ABSTRACT
Objective: Management of splenic injury is a challenging surgical emergency. The spleen has important immunologic functions. Therefore, conservation of the spleen after trauma-whenever possible - is necessary. The present study was carried out to assess the efficacy of topical fibrin sealants [fibrin glue] in comparison with gelatin sponge [gelfoam] and oxidized regenerated cellulose [surgicel] in a rat spleen trauma model
Material and Methods: A standardized traumatic splenic injury was inflicted in male Sprague-Dawley albino albino rats. Animals were divided into four groups [10 rats per group]. Rats that were managed only with surgical gauze served as controls [group 1]. The rest of the animals were categorized as follows; gel foam [group2], surgicel [group 3] and fibrin glue [group 4]. The time necessary to achieve hemostasis was recorded for each rat. Spleens were removed 72 hours later to examine the histopathological parenchymal effects of the topical agents
Results: Complete hemostasis was achieved in all animals within minutes, but fibrin glue and gel foam were significantly superior compared to the control group [p < 0.05]. The surgicel didn't show statistical significance over the control group [p> 0.05]. Moreover, the fibrin glue was significantly better in achieving hemostasis compared to the gel foam [p < 0.05]. Histopathological findings showed that the gelfoam exhibited the most severe inflammatory reaction, while the surgicel caused a moderate inflammatory reaction. Fibrin glue constituted the least inflammatory parenchymal reaction
Conclusion: The present study illustrated that the use of fibrin sealants can be considered an efficient reliable method of attaining hemostasis after splenic injury. Larger prospective clinical studies are recommended