Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Kashihara, Japan.
Department of Cardiovascular Surgery, Iseikai Hospital, Osaka, Japan.
Interact Cardiovasc Thorac Surg. 2022 May 2;34(5):849-856. doi: 10.1093/icvts/ivab370.
Although reoperation has been increasingly performed in cardiovascular surgery in recent years, preventing surgical adhesions remains an unsolved complication. Therefore, this study aimed to investigate whether gelatine sealing sheets are more effective than fibrin sealing sheets in preventing surgical adhesions.
Bilateral femoral arteries of 20 beagle dogs under general anaesthesia were pricked with syringe needles, and gelatine and fibrin sealing sheets were applied on the bleeding points to make canine adhesion models. The femoral artery was harvested after 4 and 12 weeks to evaluate adhesion formations. The adhesive grade was quantified by scoring the area and strength of adhesion tissues. Histological staining was performed to examine the structural features of surgical adhesions.
Significantly fewer macroscopic adhesions were observed with gelatine sealing sheets than those with fibrin sealing sheets at 4 and 12 weeks postoperatively. Microscopically, CD3+ T lymphocytes at 4 and 12 weeks postoperatively in gelatine sealing sheets were significantly lower than those in fibrin sealing sheets. Microvessel density determined by CD34 at 4 and 12 weeks postoperatively in gelatine sealing sheets was also significantly lower than those in fibrin sealing sheets.
The gelatine sealing sheets are more effective than the fibrin sealing sheets in preventing surgical adhesions. These findings suggest that the gelatine sealing sheet may help prevent adhesions and thus be a therapeutically effective biomaterial in vascular surgery.
尽管近年来心血管外科手术中的再次手术日益增多,但预防手术粘连仍然是一个尚未解决的并发症。因此,本研究旨在探讨明胶密封片是否比纤维蛋白密封片更能有效预防手术粘连。
在全身麻醉下用注射器针头刺破 20 只比格犬的双侧股动脉,在出血点应用明胶和纤维蛋白密封片制作犬粘连模型。术后 4 周和 12 周取出股动脉,评估粘连形成情况。通过评分评估粘连组织的面积和强度来量化粘连等级。进行组织学染色以检查手术粘连的结构特征。
术后 4 周和 12 周,明胶密封片组的肉眼粘连明显少于纤维蛋白密封片组。术后 4 周和 12 周,明胶密封片中的 CD3+T 淋巴细胞明显低于纤维蛋白密封片中的 CD3+T 淋巴细胞。术后 4 周和 12 周,明胶密封片中的 CD34 确定的微血管密度也明显低于纤维蛋白密封片中的微血管密度。
明胶密封片在预防手术粘连方面比纤维蛋白密封片更有效。这些发现表明,明胶密封片可能有助于预防粘连,因此在血管外科中是一种有治疗效果的生物材料。