USE OF FIBRIN GLUE TO PROTECT TISSUE DURING CO2-LASER SURGERY

Objective: Accidental injury of tissues during CO2 laser irradiation c an lead to serious morbidity, especially during ear, nose, and throat, neurosurgical, and plastic-reconstructive procedures. This experiment al study describes a new technique in which vital structures are coate d with a thin layer of fibrin glue to protect them from accidental CO2 laser irradiation. Study Design/Materials and Methods: The femoral ne urovascular bundles (femoral artery, vein, and nerve) of 12 rats were exposed. On one side the bundle was coated with fibrin glue, which is a biological two-component glue consisting of fibrinogen solution and thrombin, Upon application, an elastic mass on the neurovascular bundl e was formed. The contralateral neurovascular bundle was left uncoated , Subsequently both bundles were subjected to CO2 laser irradiation at different powers (5, 7, and 9 W), with an irradiation time of 0.1 sec onds. Light microscopy was performed at 30 minutes and 2 days after su rgery. Results: No macroscopic visible hemorrhages occurred during las er irradiation in the glue-coated bundle. Light microscopic evaluation revealed an undamaged neurovascular bundle without any signs of therm al damage. In the uncoated bundles intraoperative hemorrhages resultin g from laser energy occurred in all specimens. Furthermore, severe the rmal damage was present in arteries, veins, and nerves. Conclusions: I ntraoperative coating with fibrin glue can serve as a shield to protec t vital structures such as arteries, veins, and nerves from accidental CO2 laser exposure.