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Rivista di Chirurgia Cardiaca, Vascolare e Toracica

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The Journal of Cardiovascular Surgery 2003 February;44(1):109-13

lingua: Inglese

Experimental use of an albumin-glutaraldehyde tissue adhesive for sealing tracheal anastomoses

Herget G. W. 1, Riede U. N. 2, Kassa M. 1, Brethner L. 1, Hasse J. 1

1 Depart­ment of Tho­racic Sur­gery Uni­ver­sity of Frei­burg, Frei­burg i. Br., Ger­many
2 Insti­tute of ­Pathology Ludwig-­Aschoff-­Haus Frei­burg i. Br., Ger­many


Aim. The pur­pose of ­this ­study was to ­test the per­for­mance of an ­albumin-glu­ta­ral­de­hyde ­tissue adhe­sive (Bio­Glue®, man­u­fac­tured by Cryo­Life Inc., ­Kennesaw, GA, USA) ­when ­used on tra­cheal resec­tions in rab­bits, ­which is a sen­si­tive ­model to inves­ti­gate the bio­com­pat­ibility of the ­glue.
­Methods. The 24 ani­mals ­were anes­the­tized and under­went cer­vi­cotomy ­with resec­tion of a 10 mm ­long tra­cheal seg­ment. The experi­mental ­group (18 ani­mals ­with 2, 4 and 12 ­week end­points) had a tra­cheal anas­tom­osis per­formed ­with a max­imum of 4 ­sutures for the approx­i­ma­tion of the ­tissue mar­gins. The anas­to­motic ­line was ­then cir­cum­fe­ren­tially cov­ered ­with the adhe­sive. Con­trol ani­mals (6 animals, 4 ­week end­point) had a tra­cheal anas­tom­osis per­formed ­with the use of ­twice inter­rupted, air­tight run­ning ­suture. The experi­ments ­were con­ducted ­after ­approval by the Insti­tu­tional ­Ethics Com­mittee and in accor­dance ­with the Euro­pean Con­ven­tion on ­Animal ­Care.
­Results. Mac­ro­scopic eval­u­a­tion ­revealed a ­tight clo­sure of the anas­tom­osis in 23 ani­mals. One ­rabbit devel­oped tra­cheo-cuta­neous fis­tula, 2 rab­bits expe­ri­enced intra­lu­minal gran­u­la­tions due to infec­tion, and 1 ­rabbit devel­oped tra­cheal sten­osis due to insuf­fi­cient ­sutures ­with ­axis-dis­place­ment of the anas­to­mosed tra­cheal ­lumina. On micro­scopic exam­ina­tion, ­after 2 ­weeks an inflam­ma­tory ­tissue ­response con­sisting of neu­trophils, mac­ro­phages and for­eign ­body ­giant ­cells was ­found sur­rounding the ­glued ­area. ­After 4 ­weeks the ­tissue was gran­u­lom­a­tous in char­acter ­with an ­increasing ­number of mul­ti­nu­cle­ated ­giant ­cells. In gen­eral, per­sis­tent gran­u­lom­a­tous inflam­ma­tion and ­fibrous ­scar ­tissue was ­seen ­after 12 ­weeks. ­Both, mac­ro­scop­i­cally and micro­scop­i­cally, fibro­an­gio­blastic ­tissue ­responses ­were ­found in the con­trol ­group ­after 4 ­weeks.
Con­clu­sion. ­Despite sec­on­dary ­healing dis­rup­tions ­such as gra­nu­loma for­ma­tion, our inves­ti­ga­tions sug­gest ­that the ­results of albumin-glutaraldehyde tissue adhesive ­sealed tra­cheal anas­to­moses ­with a few approx­i­mating ­sutures are com­par­able ­with ­those ­using ­suture tech­nique. ­Short ­term ­results dem­on­strated ­good bio­com­pat­ibility of the ­glue.

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