HEMOSTASIS AND HEALING OF SUPERFICIAL SPLENIC INJURIES USING ND-YAG LASER AND NONSUTURE TECHNIQUES - PRELIMINARY-REPORT

This study was designed to compare Nd:YAG; laser to fibrin glue, elect rocautery, and avitene in the management of superficial splenic injury . Six dogs were submitted to laparotomy. A #11 blade scalpel was used to sharply excise the splenic capsule inflicting four 1'' x 1'' superf icial injuries on each spleen. The lesions were treated. All animals h ad a second laparotomy (''first relaparotomy''); 2 dogs each were reex plored on postop days 3, 7, and 14. Morphologic and histologic observa tions were made. A third and final relaparotomy was performed on all d ogs at 21 days with repeated morphologic and histologic assessments. H emostatic times, grades of adhesions, and microscopic changes were not significantly different among the various treatments (P > 0.25). Caps ular plaque formations were significantly different at the first relap arotomy (P < 0.01) and at final relaparotomy (P < 0.05). Both adhesion s and capsular plaque formation were least at fibrin glue-treated site s, whereas Nd:YAG (1.06 mu m) was most effective for average hemostati c time (mean = 109.67 s). Electrocautery produced the greatest necrosi s at treatment sites. We conclude that all modalities are effective in controlling hemorrhage. (C) 1994 Wiley-Liss, Inc.