Title: The Role of Fibrin Glue for Splenic Salvage in Grade I and II Splenic Injuries in Albino Rats and Rabbits
Authors: Dr Shashikant Verma, Dr Ashutosh Silodia, Dr Mallika Sinha
DOI: https://dx.doi.org/10.18535/jmscr/v6i9.85
Abstract
Introduction: Spleen is one of the most commonly injured abdominal organ in blunt trauma. Iatrogenic splenic injury accounts for 20% of all splenectomy. A better understanding of importance of the spleen, its role in immune response and increased awareness of "post splenectomy sepsis" syndrome has led to the concept of splenic salvage surgery. Thus this experimental study was done to assess the role of fibrin glue for splenic salvage in grade I and II splenic injuries in albino rats and rabbits
Method: In this study, 60 healthy albino rats and 20 rabbits were used. All albino rats were randomly divided into three groups and rabbits into two groups. Laparotomy was done in all groups and superficial lacerations were made, then fibrin glue application or splenorrhaphy or no intervention was done according to different groups.
Observation: In rabbits all were show healing, there was no difference between the fibrin glue and splenorrhaphy group (P>0.05). There was higher grade of adhesion in higher grade of tear and the difference was statistically significant (P<0.05). In rats, 3 of the 20 rats (15%) in the control group without intervention showed no healing while all of the 20 rats (100%) in the fibrin glue & splenorrhaphy group respectively healed. Even in rats the difference between the 3 groups was not statistically significant (P>0.05).
Conclusion: Splenorrhaphy and fibrin glue application had no significant difference in healing. Splenorrhaphy had significantly more and higher grades of adhesions than fibrin glue application. Grade of adhesions increased with increasing grade of tear in both rats and rabbits.
Keywords: Fibrin glue, Splenorrhaphy, Adhesion, Shackford’s classification.
References
- McAnena OJ, Moore EE, Marx JA. Initial evaluation of the patient with Blunt abdominal trauma. SurgClin of North Am 1990;70:495
- Wilson RH, Moorehead RJ. Management of splenic trauma. Injury 1992;23:5.
- Mathew J, Kuenhart MD. Acute injury to adult spleen: evolution in diagnosis and management. P&S Medical Review: Nov1993;1:1
- Upadhyay P: Conservative management of splenic trauma: history and current trends. PediatrSurg Int. 2003;19: 617-627.
- Stecher VJ, Sorkin E. the chemical activity of fibrin lysis products. Int Arch Allergy Appl Immuno11972;43:879-86.
- Pohl J, Bruhn HD, Christopher E. Thrombin and fibrin induced growth of fibroblast: role in wound repair and thrombus organiszation. KlinWochenschr 1979;57:273-7.
- Kuzu et al.Use of autologous fibrin glue in the treatment of splenic trauma: an experimental study. J R CollSurg Edinb 1992;37:162-165.
- Kram et al. Splenic salvage using biologic glue. Arch Surg 1984;119:1309-11.
- Schelling et al. Application of fibrinogen-thrombin-collagen based hemostypic agent in experimental injuries of liver and spleen. J Trauma 1988;28(4):472-5.
- Shackford SR, Sise WJ, Veergilio RW, Peters RM. Evolution of splenorrhaphy: a grading system for splenic trauma. J Trauma.1981; 21:538-542.