Effect of thrombin concentration on the prevention of postoperative cerebrospinal leakage by fibrin glue / 中国组织工程研究

ABSTRACT

BACKGROUND: Fibrin glue is commonly used to prevent postoperative cerebrospinal fluid leakage from dural injuries. However, fibrin glue with standard-concentration thrombin coagulates too fast, resulting in poor adhesion of dural mater. Effect of low-concentration thrombin fibrin glue on sealing dural injuries to prevent cerebrospinal fluid leakage is unclear. OBJECTIVE: To compare the effect of low-concentration thrombin and standard-concentration thrombin on the prevention of cerebrospinal fluid leakage from dural injuries by fibrin glue. METHODS: Forty patients including 25 males and 15 females with dural injuries admitted at Fifth People’s Hospital of Chengdu from May 2017 to December 2019 were enrolled. Patients were randomly divided into two groups, 20 patients in each group. In low-concentration thrombin group, dural injuries were sealed with fibrin glue prepared with low-concentration thrombin solution (100 IU/mL). In standard-concentration thrombin group, dural injuries were sealed with fibrin glue prepared with standard-concentration thrombin solution (500 IU/mL). All patients were followed up for 2 months. The incidence of cerebrospinal fluid leakage, cumulative drainage flow, drainage duration and incision complications were compared between the two groups. The study was approved by Ethics Committee of Fifth People’s Hospital of Chengdu. RESULTS AND CONCLUSION: (1) The incidence of cerebrospinal leakage, accumulative volume and duration of drainage in the low-concentration thrombin group were lower than those of standard-concentration thrombin group (P 0.05). (3) These results indicate that fibrin glue prepared with low-concentration thrombin solution decreases the rate of cerebrospinal leakage, reduces the drainage volume and shortens the duration of drainage, which is demonstrated to be an effective strategy for sealing dural injuries.