Hemostatic effect of human fibrin glue on bleeding surface of the brain: An experiment on albino Wistar rats

Background Achieving and maintaining hemostasis in neurosurgical procedures is critical to the outcome and challenging especially in cases of coagulopathy with diffuse oozing. After trauma to the brain, a cascade of events initiated by tissue factor (TF) or thromboplastin results in a defective coagulation process that even may lead to disseminated intravascular coagulation (DIC). Fibrin glue is sealant made up of fibrinogen and thrombin used for dural defect repair at the base, convexity, anastomosis of the nerve and nerve graft, reinforcing microvascular anastomosis. This study was carried out to determine the hemostatic effect of human fibrin glue on bleeding surface of brain and compare the effect with conventional methods of hemostasis. Method Thirty (30) white rats (Rattus novergicus) were divided equally into study and control group. After craniotomy and dural opening a stab incision was made on right frontal region of brain. In case group the bleeding was controlled with fibrin glue (average 0.5 ml) and in control group conventional method of hemostasis (cautery, cottonoid patty, and saline wash, surgicel) was used. Both the groups were studied for bleeding time, seizure, neurological deficit, wound complications and mortality. Results Outcome was assessed as 1) Bleeding in both the groups 2) Complications in both the groups. It was observed that in study group the time taken in hemostasis was significantly less in comparison to the control, No significant difference in the post procedure clinical outcome and inflammatory reaction/gliosis reaction was found in both the groups. Conclusion Human fibrin glue is simple, easy and safe alternative to conventional methods of hemostasis.