Abstract
BACKGROUND: Even when properly performed, arterial sutures are not always absolutely hemostatic. Tissue sealants and adhesives have become available that can be used to complete sutures, preventing hemorrhage problems.OBJECTIVES: To evaluate the effectiveness of cyanoacrylate adhesive for sealing aortotomies in rabbits in a coagulopathic state, by analyzing survival of the animals and the time taken to achieve hemostasis.METHODS: Ten-mm long aortotomies were performed on the infrarenal aortas of 12 animals. In four animals, aortorrhaphy was conducted using four interrupted polypropylene sutures and in the remaining animals aortorrhaphy was performed using four or fewer polypropylene stitches, followed by application of a cyanoacrylate adhesive.RESULTS: The four animals sutured without adhesive died within the postoperative period due to severe hemorrhage (3 animals) or intestinal ischemia. The eight animals to which the adhesive was applied exhibited no transoperative bleeding, but one animal died during the postoperative period. Using cyanoacrylate permitted more rapid procedures (p<0.004) and no local reactions were observed in macroscopic examination of tissues.CONCLUSIONS: The cyanoacrylate adhesive demonstrated effectiveness for sealing aortotomies, considering the survival outcomes, duration of procedures and absence of local reactions on macroscopic examination.
Highlights
Routine arterial closure using surgical sutures is effective in the great majority of cases and patients have benefited from the technique for many years
All four animals in which the aortotomy was closed using four separate 7-0 polypropylene sutures without the adhesive suffered severe hemorrhages when the distal vascular clamp fitted to the aorta was opened
Three of them died the day after the operation due to complications of the severe hemorrhage that occurred when the aorta clamp was opened
Summary
Routine arterial closure using surgical sutures is effective in the great majority of cases and patients have benefited from the technique for many years. Surgical sealants and adhesives have recently become available and can be used to supplement sutures, preventing hemorrhagic problems. Tissue sealants and adhesives have become available that can be used to complete sutures, preventing hemorrhage problems. Objectives: To evaluate the effectiveness of cyanoacrylate adhesive for sealing aortotomies in rabbits in a coagulopathic state, by analyzing survival of the animals and the time taken to achieve hemostasis. Results: The four animals sutured without adhesive died within the postoperative period due to severe hemorrhage (3 animals) or intestinal ischemia. Using cyanoacrylate permitted more rapid procedures (p
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