ACUTE THROMBOGENIC EFFECTS OF FIBRIN SEALANT ON MICROVASCULAR ANASTOMOSES IN A RAT MODEL

Topically applied bioadhesives and hemostatic agents have gained wide acceptance in various surgical endeavors. However, the effect of throm bin-based fibrin sealant (fibrin glue) when applied to microvascular a nastomoses has not been evaluated thoroughly. Although fibrin sealant has been used directly on vascular anastomoses in macrovascular surger y, there has been little exploration into the utility and potential co mplications when used in the microsurgical setting. This study explore d the influence of fibrin sealant containing increasing concentrations of bovine thrombin on microvascular anastomoses in a rat epigastric f ree flap model. The survival of the free flap in this model appeared t o be inversely proportional to the concentration of thrombin in the fi brin sealant. When thrombin atone was applied to the anastomoses, the rate of thrombosis was the highest. Venous anastomosis was the most se nsitive to the deleterious effects of topically applied thrombin.