Kang D R, Leong H, Foss R, Martin P, Brooker C R, Seid A B
Department of Otolaryngology, Naval Medical Center, San Diego, Calif 92134-5000, USA.
Arch Otolaryngol Head Neck Surg. 1998 Jun;124(6):665-70. doi: 10.1001/archotol.124.6.665.
To determine whether fibrin sealant can replace suture as a means of holding a cartilage graft securely in the trachea.
Randomized blinded control study comparing the use of fibrin sealant vs sutures in laryngotracheal reconstruction in ferrets. We compared results at 7 and 30 days.
Forty ferrets randomized into 2 groups of 20: fibrin sealant and sutures. Within each group, half were studied at 7 days and the rest at 30 days. No ferrets were withdrawn from study because of adverse effects of the intervention.
A carved costal cartilage graft was placed in the anterior cricoid split incision, and was secured with either fibrin sealant or sutures. All animals were extubated after recovery from anesthesia. Specimens were examined grossly and histologically.
All animals survived until humanely killed. The pathologist, unaware of the groupings, measured lumen expansion in millimeters, cartilage graft migration, mucosal in-growth, degree of inflammation, graft integration, and graft viability. The fibrin sealant group had statistically significant (P<.05) better results in mucosal in-growth. In no categories was the suture group better than the fibrin sealant group. In comparing 7-day with 30-day results, the 30-day group had significantly better results in inflammation and graft viability.
Fibrin sealant can be used in place of sutures with improvement in mucosal growth in costal cartilage laryngotracheal reconstruction in the experimental animal model. Use of fibrin sealant (instead of sutures) may result in less surgical trauma and edema, less surgical time, and faster recovery.
确定纤维蛋白密封剂是否可替代缝线，作为将软骨移植物牢固固定于气管的一种方法。
在雪貂喉气管重建中，比较纤维蛋白密封剂与缝线使用情况的随机双盲对照研究。我们比较了7天和30天时的结果。
40只雪貂随机分为两组，每组20只：纤维蛋白密封剂组和缝线组。每组中，一半在7天时进行研究，其余在30天时进行研究。没有雪貂因干预措施的不良反应而退出研究。
将雕刻好的肋软骨移植物置于环状软骨前裂开切口中，并用纤维蛋白密封剂或缝线固定。所有动物在麻醉恢复后拔管。对标本进行大体和组织学检查。
所有动物均存活至被人道处死。病理学家在不知道分组情况的前提下，测量了以毫米为单位的管腔扩张、软骨移植物移位、黏膜向内生长、炎症程度、移植物整合情况及移植物活力。纤维蛋白密封剂组在黏膜向内生长方面有统计学意义上的显著更好结果（P<0.05）。在任何类别中，缝线组都不比纤维蛋白密封剂组好。在比较7天和30天的结果时，30天组在炎症和移植物活力方面有显著更好的结果。
在实验动物模型的肋软骨喉气管重建中，纤维蛋白密封剂可替代缝线使用，并改善黏膜生长。使用纤维蛋白密封剂（而非缝线）可能导致手术创伤和水肿更小、手术时间更短以及恢复更快。
