Preservation of the spleen using human fibrin seal.

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.