EVALUATION OF CANINE-DERIVED FIBRIN SEALANT AS A HEMOSTATIC AGENT

The purpose of this study was to determine whether canine-derived fibr inogen concentrate applied with bovine thrombin was a safe and effecti ve topical hemostatic agent. A canine liver biopsy model was selected to test this product. Cryoprecipitate was prepared from frozen canine plasma using two freeze/thaw/centrifugation cycles. Six healthy adult dogs (weighing more than 18 kg) were used in the fibrin sealant study, and an additional three dogs were used as controls for the liver biop sy. A 1 X 3 cm fiver biopsy specimen was obtained, digital pressure wa s applied to reduce bleeding, and the fibrinogen concentrate was immed iately sprayed on the bleeding surface simultaneously with bovine thro mbin (1,000 IU/mL). The mean +/- standard error of the mean (SEM) bloo d pressure at time of biopsy was 98 +/- 9 mm Hg, and the rate of hemor rhage from the cut liver edge was 8.0 +/- 1.1 mL/min. The total blood loss during fibrin sealant application was 37 +/- 9 mL and total time for hemostasis was 5.5 +/- 1.3 minutes. There was no additional hemorr hage after application of the fibrin sealant. In the three control dog s, fibrin sealant was not applied and only digital compression was use d to decrease hemorrhage. Before digital compression, the rate of hemo rrhage from the cut liver edge was 13.1 +/- 3.1 mL/min. Bleeding had n ot stopped after 10 minutes of compression and the mean postcompressio n rate of hemorrhage was 4.0 +/- 2.6 mL/min. Signs of secondary bleedi ng after fibrin sealant was applied were not evident during the immedi ate postoperative period or over the next 14 days. The coagulation pro file, alanine amino transferase (ALT), alkaline phosphatase (AP), and bile acids were not significantly different on day 14 from preoperativ e values, suggesting that the liver was only mildly affected. The dogs were euthanatized and gross and histological examinations of the biop sy site were performed on day 14. There were minimal or no adhesions a t the biopsy site. In all dogs, the hepatic capsule was less than 1 mm thick and histological signs of secondary bleeding, hepatocellular da mage, thrombosis, infection, or inflammation were not observed. In thi s study, canine-derived fibrin sealant was a safe and effective topica l hemostatic agent. (C) Copyright 1994 by The American College of Vete rinary Surgeons