Inhibition of intra-abdominal adhesions: A comparison of Hemaseel APR and cryoprecipitate fibrin glue

Our previous studies demonstrated fibrin glue (FG) prepared from cryoprecip itate (cryo) inhibits intra-abdominal adhesions in rats. A new FG, Hemaseel APR, is Food and Drug Administration (FDA) approved for hemostasis during cardiac surgery and splenic trauma. This study was undertaken to determine if Hemaseel FG prevents intra-abdominal adhesions, and to compare it to cry o FG. Forty-five rats underwent laparotomy. Bilateral peritoneal-muscular d efects were created. Polypropylene mesh was sewn into each defect with a ru nning silk suture. The bowel was abraded with gauze. The rats were then ran domized to mesh covered with Hemaseel FG, cryo FG, or control. On postopera tive day 7, the severity of adhesions were graded by percentage of mesh cov ered by adhesion (0-100%) and degree of adhesion (0-3). The mean percentage of mesh covered by adhesion was 9% for Hemaseel FG, 43% for cryo FG (p = . 005), and 65% for the controls (p < .0001). The mean density adhesion score was 0.5 for Hemaseel FG, 1.2 for cryo FG (p = .04), and 2.1 for the contro ls (p < .0001). In the Hemaseel FG group, 77% of patches had no adhesions, compared with 37% in the cryo FG group (p = .004) and 13% in the controls ( p < .0001). Thus, Hemaseel FG significantly decreases intra-abdominal adhes ions, and is more effective than cryo FG.