Autologous Fibrin Sealant Research Articles

The co-application of sprayed cultured autologous keratinocytes and autologous fibrin sealant in a porcine wound model

We have explored the potential for cultured autologous keratinocytes to form an epidermis when delivered as a spray intermixed with autologous fibrin sealant. Twelve full-thickness wounds in Large White pigs (six wounds in each of two pigs) were isolated from the surrounding skin by 4 cm diameter polytetrafluoroethylene chambers, and grafted with Integra artificial skin (Ethicon). Autologous fibrin sealant was produced 10 days later, using an automated processor unit (Vivostat System, ConvaTec, Bristol Myers Squibb), from 120 ml of autologous citrated blood taken 30 min before keratinocyte application. Nine wounds were sprayed, using a Vivostat System automated applicator unit, with a mixture of the sealant preparation and freshly trypsinised cultured autologous keratinocytes in growth medium, at a density of 1-3 x 10(5) cm(-2). Three control wounds were sprayed with the same mixture without cells. The sealant-cell mixture polymerised and adhered to the wound surface immediately. Histological analysis of biopsies taken following sealant-cell application showed that isolated spherical keratinocytes were distributed throughout the sealant at between 3.1 x 10(4) cm(-2) and 7.6 x 10(4) cm(-2). After 4 days discreet colonies of keratinocytes were observed on the wound bed. At 14 days a multi-layered undulating epidermis was formed, punctuated by sporadic epidermal cysts; the mean area of epithelium was 50.1% (s.d. = 19.7%, n = 9). There was no epithelium in the controls (s.d. = 0, n = 3). The difference was statistically significant (P=0.016). This study suggests that co-sprayed cultured keratinocytes and autologous fibrin sealant may be an effective means of delivering epithelial cells to assist wound healing.

Vivostat system autologous fibrin sealant: Preliminary study in elective coronary bypass grafting: Kjaergard HK, Trumbull HR. Ann Thorac Surg 66:482–486, 1998

Vivostat system autologous fibrin sealant: Preliminary study in elective coronary bypass grafting: Kjaergard HK, Trumbull HR. Ann Thorac Surg 66:482–486, 1998

Vivostat system autologous fibrin sealant: preliminary study in elective coronary bypass grafting

Background. The Vivostat System is a medical device for the preparation of an autologous fibrin sealant from 120 mL of the patient’s blood in the operating room. The system is fully automated and microprocessor controlled and is made up of three components: an automated processor unit, an automated applicator unit, and a disposable, single-patient–use unit, which includes a preparation set and a Spraypen applicator. The biochemical process is initiated by batroxobin, which acts upon the fibrinogen in the patient’s plasma. The completion of the process depends entirely on endogenous thrombin in producing the sealant. Methods. Twenty-four volunteer patients undergoing elective primary coronary artery bypass grafting were randomized to either conventional hemostasis (control group) or the use of Vivostat fibrin sealant as an adjunct to conventional hemostasis. The patients were followed up at 1 month and 1 year. Results. The preparation process was completed in 30 minutes. No safety issues associated with the use of the sealant were identified. From 120 mL of the patient’s blood the yield of fibrin sealant was 4.5 mL (range, 3.9 to 4.8 mL). There was a favorable trend toward lower amounts of chest tube drainage in the Vivostat group. In the Vivostat group, 1 of 11 patients (9%) required a perioperative transfusion and in the control group 3 of 12 patients (25%) required a perioperative transfusion. Conclusions. It is possible to prepare autologous fibrin sealant with the Vivostat system in 30 minutes. No exogenous thrombin is required. The sealant has no known adverse effects and may prove to be a useful adjunct to hemostasis in cardiothoracic surgery.

Autologous fibrin sealant in reconstructive rabbit oviduct microsurgery

A simple method for preparing concentrated fibrinogen for use in a tissue adhesive system is described. Approximately 75% to 80% of the plasma fibrinogen can be separated and concentrated within 45 to 60 minutes from a small blood sample collected from the patient before the operation. Autologous fibrinogen prepared by this method was evaluated in reconstructive microsurgery of the rabbit oviduct.