Prevention of postoperative pericardial adhesions with TachoSil
Standard
Prevention of postoperative pericardial adhesions with TachoSil. / Kuschel, Tarah J; Gruszka, Anna; Hermanns-Sachweh, Benita; Elyakoubi, Jaouad; Sachweh, Joerg S; Vázquez-Jiménez, Jaime F; Schnoering, Heike.
In: ANN THORAC SURG, Vol. 95, No. 1, 01.2013, p. 183-188.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Prevention of postoperative pericardial adhesions with TachoSil
AU - Kuschel, Tarah J
AU - Gruszka, Anna
AU - Hermanns-Sachweh, Benita
AU - Elyakoubi, Jaouad
AU - Sachweh, Joerg S
AU - Vázquez-Jiménez, Jaime F
AU - Schnoering, Heike
N1 - Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
PY - 2013/1
Y1 - 2013/1
N2 - BACKGROUND: The prevention of the pericardial adhesions largely accountable for the technical difficulty and risk of injury inherent to resternotomy continues to gain in importance with the increasing frequency of reoperations. The hemostatic sponge TachoSil (Nycomed Austria GmbH, Linz, Austria), has shown promising results in adhesion prevention in several regions of the body. This study was designed to evaluate its effectiveness in the prevention of pericardial adhesions in comparison with the Gore-Tex (W. L. Gore and Assoc, Flagstaff, AZ) surgical membrane and a control.METHODS: Twenty-four rabbits were distributed into 3 groups: TachoSil, Gore-Tex, or no barrier agent (control). After median sternotomy and pericardiotomy, the cardial surface was exposed to the aggravating effects of room air, irrigation, and gauze abrasion for one hour. A pericardial defect was created and repaired with one of the barrier agents, or left uncovered (control). Resternotomy was performed after 6 months for the evaluation of adhesion formation.RESULTS: Significantly fewer macroscopic adhesions were observed with TachoSil than Gore-Tex in all regions (p < 0.05) excluding the coronary arteries, where the difference in favor of TachoSil did not achieve significance (0.05< p-value <0.10). TachoSil also demonstrated significantly fewer retrosternal adhesions than the control, as well as a universal non-significant trend of fewer adhesions in all regions. The limited lesions present in the TachoSil group were filmy in nature and removed with blunt dissection relatively easily. No significant differences were found between Gore-Tex and the control. Microscopically, the least pronounced fibrosis formation and inflammatory reaction was detected with TachoSil.CONCLUSIONS: TachoSil is effective in the prevention of pericardial adhesions.
AB - BACKGROUND: The prevention of the pericardial adhesions largely accountable for the technical difficulty and risk of injury inherent to resternotomy continues to gain in importance with the increasing frequency of reoperations. The hemostatic sponge TachoSil (Nycomed Austria GmbH, Linz, Austria), has shown promising results in adhesion prevention in several regions of the body. This study was designed to evaluate its effectiveness in the prevention of pericardial adhesions in comparison with the Gore-Tex (W. L. Gore and Assoc, Flagstaff, AZ) surgical membrane and a control.METHODS: Twenty-four rabbits were distributed into 3 groups: TachoSil, Gore-Tex, or no barrier agent (control). After median sternotomy and pericardiotomy, the cardial surface was exposed to the aggravating effects of room air, irrigation, and gauze abrasion for one hour. A pericardial defect was created and repaired with one of the barrier agents, or left uncovered (control). Resternotomy was performed after 6 months for the evaluation of adhesion formation.RESULTS: Significantly fewer macroscopic adhesions were observed with TachoSil than Gore-Tex in all regions (p < 0.05) excluding the coronary arteries, where the difference in favor of TachoSil did not achieve significance (0.05< p-value <0.10). TachoSil also demonstrated significantly fewer retrosternal adhesions than the control, as well as a universal non-significant trend of fewer adhesions in all regions. The limited lesions present in the TachoSil group were filmy in nature and removed with blunt dissection relatively easily. No significant differences were found between Gore-Tex and the control. Microscopically, the least pronounced fibrosis formation and inflammatory reaction was detected with TachoSil.CONCLUSIONS: TachoSil is effective in the prevention of pericardial adhesions.
KW - Animals
KW - Disease Models, Animal
KW - Drug Combinations
KW - Female
KW - Fibrinogen
KW - Heart Diseases/etiology
KW - Pericardium/pathology
KW - Postoperative Complications/etiology
KW - Postoperative Period
KW - Rabbits
KW - Surgical Sponges
KW - Thoracic Surgical Procedures/adverse effects
KW - Thrombin
KW - Tissue Adhesions/etiology
U2 - 10.1016/j.athoracsur.2012.08.057
DO - 10.1016/j.athoracsur.2012.08.057
M3 - SCORING: Journal article
C2 - 23084416
VL - 95
SP - 183
EP - 188
JO - ANN THORAC SURG
JF - ANN THORAC SURG
SN - 0003-4975
IS - 1
ER -
