Effect of Thrombin Concentration on the Adhesion Strength and Clinical Application of Fibrin Glue-Soaked Sponge

Campos, Francia; Shimizu, Fujio; Sugata, Sei; Tokimura, Hiroshi; Hanaya, Ryosuke; Bohara, Manoj; Arita, Kazunori

doi:10.2176/nmc.53.17

Cited by 7 publications

(3 citation statements)

References 22 publications

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“…The sellar floor was reconstructed with a vomer splint and covered again with FGGS. We have previously presented the details of this method [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical aspects in craniopharyngioma treatment

Shimizu

Hanada

Yonenaga

et al. 2020

Innovative Surgical Sciences

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ObjectivesTotal surgical resection is the gold standard in the treatment of craniopharyngioma. However, there is concern that aggressive surgical resection might result in high rates of endocrinologic, metabolic, and behavioral morbidities. Subtotal resection (SR) with subsequent radiation therapy (RT) may reduce surgical complications, but it may also increase the risk of tumor recurrence and radiation-induced side effects. Therefore, the optimal surgical strategy remains debatable.MethodsTo determine the optimal surgical strategy, we assessed the clinical courses of 39 patients (19 male patients and 20 female patients) with newly diagnosed craniopharyngioma who were treated at our institute. The median age at diagnosis was 34 years (range: 0–76 years). The median follow-up period was 8.5 years (range: 3–160 months). Our treatment strategy comprised gross total resection (GTR) for craniopharyngioma in patients that were not at surgical risk. Conversely, after adequate tumor decompression, we used RT, mainly Gamma Knife radiosurgery, in patients at risk. We divided the patients into the following three groups depending on the treatment course: GTR, SR with RT, and SR with staged surgery. We compared tumor characteristics, as well as patients’ conditions at the preoperative stage and last follow-up, among the three groups.ResultsThere were 8, 21, and 10 patients in the GTR, SR with RT, and SR with staged surgery groups, respectively. There were no differences in the maximum tumor diameter, tumor volume, composition, and presence of calcification among the groups. Among the 39 patients, 24 underwent transcranial microsurgery and 15 underwent trans-sphenoidal surgery as the initial treatment. No cases involving surgical mortality, cerebrospinal fluid leakage, severely deteriorated visual function, or severe hypothalamic damage were observed. No tumor recurrence was noted in the GTR group. One patient required additional RT, and one patient underwent second surgery for tumor recurrence in the SR with RT group. In the SR with staged surgery group, 8 of the 10 patients eventually underwent RT, but tumor control was achieved in all patients at the latest follow-up. In this group, the third trans-sphenoidal surgery caused a severe vascular injury in one patient. At the final follow-up, 33 (85%) patients were undergoing anterior pituitary hormone replacement, and the rate of diabetes insipidus was 51%. There was no significant difference in the pituitary dysfunction rate among the groups.ConclusionsWe observed a low rate of surgical complications and a sufficient tumor control rate in response to our treatment strategy. Despite attempting preservation of the pituitary stalk, we found it difficult to rescue anterior pituitary function.

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“…The sellar floor was reconstructed with a vomer splint and covered again with FGGS. We have previously presented the details of this method [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical aspects in craniopharyngioma treatment

Shimizu

Hanada

Yonenaga

et al. 2020

Innovative Surgical Sciences

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“…We hypothesized that the combination of a topical hemostatic agent and fibrin glue would provide a synergistic effect. Several combinations have been reported[ 5 – 11 ], but the optimal combination for hemostasis is controversial. We explored the combination of commercial hemostatic agents and fibrin glue that would produce the most potent hemostatic effect in a synergistic manner.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the hemostatic effect of a combination of hemostatic agents and fibrin glue in a rabbit venous hemorrhage model

et al. 2021

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Background In neurosurgery, it is important to use local hemostatic agents. We have explored a more powerful method of hemostasis by the combination of commercially available hemostatic agents with fibrin glue in the hopes of synergistic effects. Method A bleeding model was constructed by puncturing the rabbit posterior vena cava with a needle. After applying the sample to the bleeding point, compression was performed for 10 s. If temporary hemostasis was achieved after pressure release, a 30 s wash was performed to confirm that ultimate hemostasis was achieved. Up to three hemostasis attempts were performed on the same bleeding point until hemostasis was achieved, and the number of attempts required for hemostasis was counted. If hemostasis was not achieved after three attempts, it was counted as four times. Four groups were evaluated: (1) gelatin sponge alone, (2) gelatin sponge + fibrin glue, (3) oxidized cellulose alone, and (4) oxidized cellulose + fibrin glue; each group was tested 16 times. Results The median value (range minimum value–maximum value) of the number of hemostatic attempts in Group 1 to Group 4 was 3 (1–4), 1 (1–1), 4 (4–4), and 4 (2–4). In Group 2, there were two test exclusions owing to deviations of the test procedure. Conclusions The compatibility of gelatin sponge and fibrin glue was very good, with a very strong and rapid hemostatic effect compared to other methods, showed its usefulness. This combination method may be effective for a variety of venous hemorrhages in neurosurgery.

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“…We hypothesized that the combination of a topical hemostatic agent and brin glue would provide a synergistic effect. Several combinations have been reported [5][6][7][8][9][10][11], but the optimal combination for hemostasis is controversial. We explored the combination of commercial hemostatic agents and brin glue that would produce the most potent hemostatic effect in a synergistic manner.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Hemostatic Effect of a Combination of Hemostatic Agents and Fibrin Glue in a Rabbit Venous Hemorrhage Model

Takizawa

Okazaki

Takegawa

et al. 2020

Preprint

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BackgroundIn neurosurgery, it is important to use local hemostatic agents. We have explored a more powerful method of hemostasis by the combination of commercially available hemostatic agents with fibrin glue in the hopes of synergistic effects.MethodA bleeding model was constructed by puncturing the rabbit posterior vena cava with a needle. After applying the sample to the bleeding point, compression was performed for 10 seconds. If temporary hemostasis was achieved after pressure release, a 30 second wash was performed to confirm that ultimate hemostasis was achieved. Up to three hemostasis attempts were performed on the same bleeding point until hemostasis was achieved, and the number of attempts required for hemostasis was counted. If hemostasis was not achieved after three attempts, it was counted as four times. Four groups were evaluated: (1) gelatin sponge alone, (2) gelatin sponge + fibrin glue, (3) oxidized cellulose alone, and (4) oxidized cellulose + fibrin glue; each group was tested 16 times.ResultsThe median value (range minimum value–maximum value) of the number of hemostatic attempts in Group 1 to Group 4 was 3 (1–4), 1 (1–1), 4 (4–4), and 4 (2–4). In Group 2, there were two test exclusions owing to deviations of the test procedure.ConclusionsThe compatibility of gelatin sponge and fibrin glue was very good, with a very strong and rapid hemostatic effect compared to other methods, showed its usefulness. This combination method may be effective for a variety of venous hemorrhages in neurosurgery.

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Effect of Thrombin Concentration on the Adhesion Strength and Clinical Application of Fibrin Glue-Soaked Sponge

Cited by 7 publications

References 22 publications

Surgical aspects in craniopharyngioma treatment

Surgical aspects in craniopharyngioma treatment

Evaluation of the hemostatic effect of a combination of hemostatic agents and fibrin glue in a rabbit venous hemorrhage model

Evaluation of the Hemostatic Effect of a Combination of Hemostatic Agents and Fibrin Glue in a Rabbit Venous Hemorrhage Model

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