Fibrinogen-impregnated collagen as a combined haemostatic agent and antibiotic delivery system in a porcine model of splenic trauma

Objective: To assess the effect of rifampicin on the haemostatic function o f a fibrinogen-impregnated collagen fleece. Design: Laboratory experiment. Setting: Government research establishment, UK. Material: Six Large White pigs. Interventions: Four 5 cm incisions were made in the spleen of each animal. Three of the wounds were each covered with a sheet of either dry, saline-so aked or rifampicin-soaked fibrinogen-impregnated collagen. Main Outcome Measures: The bleeding time and blood loss from each wound was recorded. Systemic serum rifampicin concentrations were measured using a S taphylococcus aureus inhibition assay. Results: Dry fibrinogen-impregnated collagen resulted in significantly less blood loss (112 (21) compared with 39 (13) mi, p < 0.05) and shorter bleed ing time (16 (2) compared with 9 (1) min, p < 0.01) than in untreated contr ol wounds. Pre-soaking in saline or rifampicin solution had no significant effect on its haemostatic function. Rifampicin concentrations above the min imum inhibitory concentration were recorded in the systemic circulation 45 minutes after injury and persisted for the duration of the experiment. Conclusions: Fibrinogen-impregnated collagen is an effective haemostatic ag ent in splenic trauma that may be of use for both the local and systemic de livery of antibiotics.