Schelling G, Block T, Gokel M, Blanke E, Hammer C, Brendel W
Institute of Surgical Research, University of Munich, W.-Germany.
J Trauma. 1988 Apr;28(4):472-5. doi: 10.1097/00005373-198804000-00009.
FTCH is a recently developed material which consists of a collagen fleece containing fibrinogen, thrombin, and aprotinin integrated into its surface. FTCH is highly effective in sealing of tissues and in establishing hemostasis. We evaluated FTCH in experimentally produced liver (n = 6) and splenic (n = 12) injuries in 18 adult mongrel dogs. The stability of the parenchymal seal of the splenic injuries was tested by splenic tissue pressure elevation after temporary ligation of the splenic vein. No breakthrough bleeding occurred up to a parenchymal pressure of 16.3 +/- 5 mm Hg. Complete hemostasis was easily achieved in all animals before closure. When the dogs were re-explored postoperatively at intervals of either 14 or 30 days, there was no gross evidence of recurrent bleeding. Histologic examinations demonstrated a partially regenerated capsule covering an unspecific fibrovascular granulation tissue and progressive resorption of FTCH without significant inflammatory response. We conclude the following: FTCH provides adequate hemostatic control of experimental liver and splenic injuries. FTCH has excellent tissue compatibility and can be applied easily and safely to hemorrhaging parenchymal wounds. It will not replace adequate surgical techniques, but could be useful as a quickly available and easily applicable hemostatic means in diffuse or acute bleeding of liver and spleen.
FTCH是一种最近研发的材料,它由一种胶原纤维网组成,其表面整合了纤维蛋白原、凝血酶和抑肽酶。FTCH在组织封闭和止血方面非常有效。我们在18只成年杂种犬身上对实验性造成的肝脏损伤(n = 6)和脾脏损伤(n = 12)评估了FTCH。通过暂时结扎脾静脉后脾组织压力升高来测试脾脏损伤实质封闭的稳定性。在实质压力达到16.3 +/- 5毫米汞柱之前未发生突破性出血。在所有动物闭合伤口前均轻松实现了完全止血。当在术后14天或30天间隔再次探查这些犬时,没有明显的复发出血迹象。组织学检查显示部分再生的包膜覆盖着非特异性纤维血管肉芽组织,FTCH逐渐吸收,无明显炎症反应。我们得出以下结论:FTCH对实验性肝脏和脾脏损伤提供了充分的止血控制。FTCH具有出色的组织相容性,可轻松、安全地应用于出血的实质伤口。它不会取代适当的外科技术,但可作为一种快速可用且易于应用的止血手段,用于肝脏和脾脏的弥漫性或急性出血。