Because of the spleen's role in host defence and the recognition of overwhelming post-
splenectomy sepsis, the current aim of treatment for splenic
injuries is to preserve the spleen. A number of
hemostatic agents have been used in an effort to control
bleeding but have not proved satisfactory. The authors report the results of an experiment using a two-component
fibrin seal on injured rabbit spleens. In female rabbits a longitudinal
laceration of the entire spleen was made. After 2 1/2 minutes of continuous hemorrhaging, the spleens were either not treated (5 rabbits) or treated by
splenectomy suture repair or
fibrin-seal repair.
Hemoglobin values were measured preoperatively and 3 days postoperatively. The greatest number of deaths within 14 days occurred in the untreated group. There was no difference in death rate between the treated groups; similarly, there was no difference in blood loss or fall in
hemoglobin values. Fewer adhesions formed in the
fibrin-seal group than in the others (p less than 0.02). Histopathological examination revealed a greater fibrinoblastic response in the spleens treated with
fibrin seal than in the other groups. The authors believe that
fibrin seal is an effective and safe
hemostatic agent applicable to splenic parenchymal
injuries, and that it promotes wound healing and suppresses adhesion formation.