Application of a Fibrinogen-Thrombin-Collagen-Based Hemostyptic Agent in Experimental Injuries of Liver and Spleen

Abstract

FTCH is a recently developed material which consists of a collagen fleece containing fibrinogen, thrombin, and aprotinin integrated into its surface. FTCH is highly effective in sealing of tissues and in establishing hemostasis. We evaluated FTCH in experimentally produced liver (n=6) and splenic (n=12) injuries in 18 adult mongrel dogs. The stability of the parenchymal seal of the splenic injuries was tested by splenic tissue pressure elevation after temporary ligation of the splenic vein. No breakthrough bleeding occurred up to a parenchymal pressure of 16.3 ± 5 mm Hg. Complete hemostasis was easily achieved in all animals before closure. When the dogs were re-explored postoperatively at intervals of either 14 or 30 days, there was no gross evidence of recurrent bleeding. Histologic examinations demonstrated a partially regenerated capsule covering an unspecific fibrovascular granulation tissue and progressive resorption of FTCH without significant inflammatory response. We conclude the following: FTCH provides adequate hemostatic control of experimental liver and splenic injuries. FTCH has excellent tissue compatibility and can be applied easily and safely to hemorrhaging parenchymal wounds. It will not replace adequate surgical techniques, but could be useful as a quickly available and easily applicable hemostatic means in diffuse or acute bleeding of liver and spleen.