Haverich A, Maatz W, Walterbusch G
Thorac Cardiovasc Surg. 1982 Aug;30(4):215-22. doi: 10.1055/s-2007-1022390.
This paper presents experimental investigations to evaluate fibrin seal for bleeding control under systemic heparinization as well as some of the benefits and limits of fibrin-presealing vascular prostheses. Local hemostasis using fibrin seal plus collagen fleece was achieved in 3 standardized sources of bleeding produced in mongrel dogs under full heparinization. Water porosity was measured in 3 standard prosthetic materials of different porosity. It could be shown that all graft types investigated were sufficiently sealed up to a pressure of 600 mmHg. The influence of fibrinolysis on the stability of the fibrin network in vascular grafts was tested by in vitro experiments using urokinase incubation. While water permeability increased in fibrin-sealed fabric without aprotinin added, no fibrinolysis-induced leakage was observed in those exposed to aprotinin. Surface thrombogenicity of the fibrin-sealed grafts was higher than in blood-preclotted prostheses, if not rinsed with isotonic saline. After rinsing, thrombogenicity decreased below values obtained in grafts preclotted conventionally. Survival studies in animals show no difference between blood-preclotted and fibrin-presealed prostheses both 3 and 7 days after implantation.
本文介绍了实验研究，以评估在全身肝素化情况下用于控制出血的纤维蛋白封闭剂，以及纤维蛋白预封闭血管假体的一些优点和局限性。在完全肝素化的杂种狗身上产生的3种标准化出血源中，使用纤维蛋白封闭剂加胶原绒实现了局部止血。在3种不同孔隙率的标准假体材料中测量了水孔隙率。结果表明，所有研究的移植物类型在600 mmHg的压力下都能得到充分封闭。通过使用尿激酶孵育的体外实验测试了纤维蛋白溶解对血管移植物中纤维蛋白网络稳定性的影响。在未添加抑肽酶的纤维蛋白封闭织物中，水渗透性增加，而在暴露于抑肽酶的织物中未观察到纤维蛋白溶解引起的渗漏。如果不用等渗盐水冲洗，纤维蛋白封闭移植物的表面血栓形成性高于血液预凝假体。冲洗后，血栓形成性降低到传统预凝移植物所获得的值以下。动物存活研究表明，植入后3天和7天，血液预凝假体和纤维蛋白预封闭假体之间没有差异。
