Basic Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Aug 28, 2017; 9(24): 1030-1039
Published online Aug 28, 2017. doi: 10.4254/wjh.v9.i24.1030
Novel synthetic adhesive as an effective alternative to Fibrin based adhesives
Pramod Kadaba Srinivasan, Vera Sperber, Mamdouh Afify, Hirokazu Tanaka, Kenji Fukushima, Babette Kögel, Felix Gremse, René Tolba
Pramod Kadaba Srinivasan, Vera Sperber, Mamdouh Afify, Hirokazu Tanaka, Kenji Fukushima, Babette Kögel, René Tolba, Institute for Laboratory Animal Science and Experimental Surgery, University Hospital, RWTH Aachen, 52074 Aachen, Germany
Felix Gremse, Experimental Molecular Imaging, University Hospital, RWTH Aachen, 52074 Aachen, Germany
Author contributions: Srinivasan PK and Sperber V contributed equally to this paper; Srinivasan PK, Sperber V and Tolba R contributed to study concept and design; Srinivasan PK and Sperber V contributed to acquisition of data; Tolba R, Srinivasan PK, Sperber V, Gremse F and Afify M contributed to analysis and interpretation of data; Srinivasan PK and Sperber V contributed to drafting of the manuscript; Tolba R, Srinivasan PK, Tanaka H and Fukushima K contributed to critical revision of the manuscript for important intellectual content; Tolba R and Srinivasan PK contributed to statistical analysis; Gremse F and Kögel B contributed to administrative, technical and material support; Tolba R, Srinivasan PK, Sperber V and Kögel B contributed to study supervision.
Institutional review board statement: The governmental care and use committee (LANUV), Recklinghausen, NRW, Germany, granted official permission.
Conflict-of-interest statement: MAR-1 in this study was provided by Adhesys Medical GmbH. Pramod Kadaba Srinivasan is employed as a part-time researcher at Adhesys Medical GmbH and Adhesys Medical GmbH will cover the publication costs; Vera Sperber has no conflict of interest; Mamdouh Afify has no conflict of interest; Hirokazu Tanaka has no conflict of interest; Kenji Fukushima has no conflict of interest; Babette Kögel has no conflict of interest; Felix Gremse has no conflict of interest; René Tolba is a shareholder of Adhesys Medical GmbH.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. René Tolba, Professor, Director, Institute for Laboratory Animal Science and Experimental Surgery, University Hospital, RWTH Aachen, Pauwelsstr. 30, 52074 Aachen, Germany. rtolba@ukaachen.de
Telephone: +49-241-8088606
Received: March 30, 2017
Peer-review started: March 31, 2017
First decision: May 9, 2017
Revised: June 26, 2017
Accepted: July 7, 2017
Article in press: July 10, 2017
Published online: August 28, 2017
Abstract
AIM

To compare a novel, fully synthetic, polyurethane based glue (MAR-1) to fibrin sealant in a partial liver resection rat model.

METHODS

After 50% resection of the lateral left liver lobe in male Wistar rats (n = 7/group/time point), MAR-1, Fibrin or NaCl was applied. After 14, 21 and 90 postoperative days, sealant degradation, intra-abdominal adhesions were scored, and histological examination of liver tissue was performed.

RESULTS

(Mean ± SEM) (MAR-1 vs Fibrin vs NaCl). Bleeding mass was significantly higher in NaCl (3.36 ± 0.51 g) compared to MAR-1 (1.44 ± 0.40 g) and Fibrin (1.16 ± 0.32 g). At 14 and 90 d, bleeding time was significantly lower in MAR-1 (6.00 ± 0.9 s; 13.57 ± 3.22 s) and Fibrin (3.00 ± 0.44 s; 22.2 ± 9.75 s) compared to NaCl (158.16 ± 11.36 s; 127.5 ± 23.3 s). ALT levels were significantly higher in MAR-1 (27.66 ± 1 U/L) compared to Fibrin (24.16 ± 0.98 U/L) and NaCl (23.85 ± 0.80 U/L). Intrabdominal adhesions were significantly lower in MAR-1 (11.22% ± 5.5%) compared to NaCl (58.57% ± 11.83%). Degradation of the glue was observed and MAR-1 showed almost no traces of glue in the abdominal cavity as compared to the Fibrin (10% ± 5% 14 d; 7% ± 3% 21 d). Survival showed no significant differences between the groups.

CONCLUSION

Compared to Fibrin, MAR-1 showed similar hemostatic properties, no adverse effects, and is biocompatible. Further studies on adhesion strength and biodegradability of synthetic sealants are warranted.

Keywords: MAR-1, Fibrin, Liver resection, Hemostasis, Polyurethane

Core tip: This study evaluates the effectiveness of a novel, polyurethane based, surgical adhesive on a liver resection model. This study will further help in better sealing of wounds in a trauma model in comparison to Fibrin glue.