Intraoperative use of the absorbable fibrin adhesive bandage: Long term effects

Purpose: The absorbable fibrin adhesive bandage (AFAB) reduces acute blood loss in experimental trauma models, but the effects on wound healing and su bsequent function have heretofore not been investigated. Retropubic prostat ectomy was selected to evaluate short and long term effects of using the AF AB intraoperatively. Materials and Methods: Dogs undergoing prostatectomy were randomly assigned to one of four treatments: CONTROL- sponges and manual pressure were appli ed after transecting the prostatic pedicles. Sponges were removed when the prostate was delivered. Vessels were isolated and ligated if bleeding conti nued after removal. AFAB- hemostatically active bandages were applied to th e prostatic bed prior to sponges and pressure. Additional bandages were app lied at the urethrovesical junction after completing the anastomosis. PLACE BO- visually identical (hemostatically inert) bandages were applied in an i dentical fashion. LIQUID SEALANT- concentrated thrombin and fibrinogen solu tion was applied to the vessels prior to sponges and pressure. Additional s ealant solution was applied around the anastomosis. Results: Blood loss and time to achieve hemostasis were significantly less in the AFAB group compared with the other treatments. There were no differe nces in days to anastomotic integrity, continence, or inta-abdominal adhesi ons at necropsy six weeks later. Conclusions: The AFAB can reduce surgery time and blood loss, with no decre ment in wound healing or subsequent function.