Effects of Tisseel and FloSeal on Primary Ischemic Time in a Rat Fasciocutaneous Free Flap Model

Aaron W. Partsafas, Daphne A. Bascom, Scott A. Jorgensen, Mark Wax

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives. Free flaps are the technique of choice for reconstruction of defects resulting from extirpation of tumors of the head and neck. Advances in microsurgical technique have resulted in success rates of greater than 95%. Numerous intraoperative factors, ranging from technical issues to topically applied agents, can complicate the outcome of microsurgical free tissue transfer. Synthetic tissue adhesives and hemostatic agents are playing an ever-increasing role in reconstructive surgery. The safety of these factors in free flap surgery has not been ascertained. Study Design: Animal Care Committee live rat model. Methods: Male Sprague-Dawley rats were divided into three groups: group I, Control; group 2, FloSeal; group 3, Tisseel. In each group, a 3 x 6 cm ventral fasciocutaneous groin flap based on the left superficial epigastric artery was elevated and the experimental material applied beneath the flap and around the flap pedicle prior to suturing of the flap back to the wound bed. The experimental materials consisted of 0.2 mL. saline in the control group, 0.5 mL FloSeal, and 0.2 mL Tisseel. In phase I of this study, the effect of each treatment on flap survival was assessed by survival at postoperative day 4. In phase II of the study, the effects of these agents on ischemic tolerance was investigated. Five rats in each treatment group were exposed to ischemic times of 6, 8, 10, and 12 hours. Survival of the flap was assessed 7 days after reversal of the ischemia. Probit curves and the critical ischemic time (CIT50) were calculated. Results: All flaps survived the 2-hour period of ischemia and were viable at postoperative day 4. Flap survival from group 1 (Control), group 2 (FloSeal), and group 3 (Tisseel) at the various ischemic times was as follows: at 6 hours, 80%, 80%, and 80%, respectively; at 8 hours, 80%, 80%, 60%; at 10 hours, 60%, 33%, 40%; at 12 hours, 20%, 20%, 0%. The CIT50 for the Control, FloSeal, and Tisseel groups was 9.4, 9.0, and 7.0 hours, respectively. Conclusions: FloSeal, a thrombin-based hemostatic agent, and Tisseel, a fibrin glue, displayed no adverse effect on flap survival in this model.

Original languageEnglish (US)
Pages (from-to)301-304
Number of pages4
JournalLaryngoscope
Volume114
Issue number2
DOIs
StatePublished - Feb 2004

Fingerprint

Fibrin Tissue Adhesive
Free Tissue Flaps
Hemostatics
Control Groups
Reconstructive Surgical Procedures
Ischemia
Animal Care Committees
Epigastric Arteries
Tissue Adhesives
Groin
Thrombin
Sprague Dawley Rats
Neck
Head
Safety
Wounds and Injuries
Neoplasms

Keywords

  • Fibrin glue
  • FloSeal
  • Free flap
  • Ischemia
  • Reconstruction
  • Tisseel

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Effects of Tisseel and FloSeal on Primary Ischemic Time in a Rat Fasciocutaneous Free Flap Model. / Partsafas, Aaron W.; Bascom, Daphne A.; Jorgensen, Scott A.; Wax, Mark.

In: Laryngoscope, Vol. 114, No. 2, 02.2004, p. 301-304.

Research output: Contribution to journalArticle

Partsafas, Aaron W. ; Bascom, Daphne A. ; Jorgensen, Scott A. ; Wax, Mark. / Effects of Tisseel and FloSeal on Primary Ischemic Time in a Rat Fasciocutaneous Free Flap Model. In: Laryngoscope. 2004 ; Vol. 114, No. 2. pp. 301-304.
@article{6df509a80e6844cdbe732a9795470c3f,
title = "Effects of Tisseel and FloSeal on Primary Ischemic Time in a Rat Fasciocutaneous Free Flap Model",
abstract = "Objectives. Free flaps are the technique of choice for reconstruction of defects resulting from extirpation of tumors of the head and neck. Advances in microsurgical technique have resulted in success rates of greater than 95{\%}. Numerous intraoperative factors, ranging from technical issues to topically applied agents, can complicate the outcome of microsurgical free tissue transfer. Synthetic tissue adhesives and hemostatic agents are playing an ever-increasing role in reconstructive surgery. The safety of these factors in free flap surgery has not been ascertained. Study Design: Animal Care Committee live rat model. Methods: Male Sprague-Dawley rats were divided into three groups: group I, Control; group 2, FloSeal; group 3, Tisseel. In each group, a 3 x 6 cm ventral fasciocutaneous groin flap based on the left superficial epigastric artery was elevated and the experimental material applied beneath the flap and around the flap pedicle prior to suturing of the flap back to the wound bed. The experimental materials consisted of 0.2 mL. saline in the control group, 0.5 mL FloSeal, and 0.2 mL Tisseel. In phase I of this study, the effect of each treatment on flap survival was assessed by survival at postoperative day 4. In phase II of the study, the effects of these agents on ischemic tolerance was investigated. Five rats in each treatment group were exposed to ischemic times of 6, 8, 10, and 12 hours. Survival of the flap was assessed 7 days after reversal of the ischemia. Probit curves and the critical ischemic time (CIT50) were calculated. Results: All flaps survived the 2-hour period of ischemia and were viable at postoperative day 4. Flap survival from group 1 (Control), group 2 (FloSeal), and group 3 (Tisseel) at the various ischemic times was as follows: at 6 hours, 80{\%}, 80{\%}, and 80{\%}, respectively; at 8 hours, 80{\%}, 80{\%}, 60{\%}; at 10 hours, 60{\%}, 33{\%}, 40{\%}; at 12 hours, 20{\%}, 20{\%}, 0{\%}. The CIT50 for the Control, FloSeal, and Tisseel groups was 9.4, 9.0, and 7.0 hours, respectively. Conclusions: FloSeal, a thrombin-based hemostatic agent, and Tisseel, a fibrin glue, displayed no adverse effect on flap survival in this model.",
keywords = "Fibrin glue, FloSeal, Free flap, Ischemia, Reconstruction, Tisseel",
author = "Partsafas, {Aaron W.} and Bascom, {Daphne A.} and Jorgensen, {Scott A.} and Mark Wax",
year = "2004",
month = "2",
doi = "10.1097/00005537-200402000-00023",
language = "English (US)",
volume = "114",
pages = "301--304",
journal = "Laryngoscope",
issn = "0023-852X",
publisher = "John Wiley and Sons Inc.",
number = "2",

}

TY - JOUR

T1 - Effects of Tisseel and FloSeal on Primary Ischemic Time in a Rat Fasciocutaneous Free Flap Model

AU - Partsafas, Aaron W.

AU - Bascom, Daphne A.

AU - Jorgensen, Scott A.

AU - Wax, Mark

PY - 2004/2

Y1 - 2004/2

N2 - Objectives. Free flaps are the technique of choice for reconstruction of defects resulting from extirpation of tumors of the head and neck. Advances in microsurgical technique have resulted in success rates of greater than 95%. Numerous intraoperative factors, ranging from technical issues to topically applied agents, can complicate the outcome of microsurgical free tissue transfer. Synthetic tissue adhesives and hemostatic agents are playing an ever-increasing role in reconstructive surgery. The safety of these factors in free flap surgery has not been ascertained. Study Design: Animal Care Committee live rat model. Methods: Male Sprague-Dawley rats were divided into three groups: group I, Control; group 2, FloSeal; group 3, Tisseel. In each group, a 3 x 6 cm ventral fasciocutaneous groin flap based on the left superficial epigastric artery was elevated and the experimental material applied beneath the flap and around the flap pedicle prior to suturing of the flap back to the wound bed. The experimental materials consisted of 0.2 mL. saline in the control group, 0.5 mL FloSeal, and 0.2 mL Tisseel. In phase I of this study, the effect of each treatment on flap survival was assessed by survival at postoperative day 4. In phase II of the study, the effects of these agents on ischemic tolerance was investigated. Five rats in each treatment group were exposed to ischemic times of 6, 8, 10, and 12 hours. Survival of the flap was assessed 7 days after reversal of the ischemia. Probit curves and the critical ischemic time (CIT50) were calculated. Results: All flaps survived the 2-hour period of ischemia and were viable at postoperative day 4. Flap survival from group 1 (Control), group 2 (FloSeal), and group 3 (Tisseel) at the various ischemic times was as follows: at 6 hours, 80%, 80%, and 80%, respectively; at 8 hours, 80%, 80%, 60%; at 10 hours, 60%, 33%, 40%; at 12 hours, 20%, 20%, 0%. The CIT50 for the Control, FloSeal, and Tisseel groups was 9.4, 9.0, and 7.0 hours, respectively. Conclusions: FloSeal, a thrombin-based hemostatic agent, and Tisseel, a fibrin glue, displayed no adverse effect on flap survival in this model.

AB - Objectives. Free flaps are the technique of choice for reconstruction of defects resulting from extirpation of tumors of the head and neck. Advances in microsurgical technique have resulted in success rates of greater than 95%. Numerous intraoperative factors, ranging from technical issues to topically applied agents, can complicate the outcome of microsurgical free tissue transfer. Synthetic tissue adhesives and hemostatic agents are playing an ever-increasing role in reconstructive surgery. The safety of these factors in free flap surgery has not been ascertained. Study Design: Animal Care Committee live rat model. Methods: Male Sprague-Dawley rats were divided into three groups: group I, Control; group 2, FloSeal; group 3, Tisseel. In each group, a 3 x 6 cm ventral fasciocutaneous groin flap based on the left superficial epigastric artery was elevated and the experimental material applied beneath the flap and around the flap pedicle prior to suturing of the flap back to the wound bed. The experimental materials consisted of 0.2 mL. saline in the control group, 0.5 mL FloSeal, and 0.2 mL Tisseel. In phase I of this study, the effect of each treatment on flap survival was assessed by survival at postoperative day 4. In phase II of the study, the effects of these agents on ischemic tolerance was investigated. Five rats in each treatment group were exposed to ischemic times of 6, 8, 10, and 12 hours. Survival of the flap was assessed 7 days after reversal of the ischemia. Probit curves and the critical ischemic time (CIT50) were calculated. Results: All flaps survived the 2-hour period of ischemia and were viable at postoperative day 4. Flap survival from group 1 (Control), group 2 (FloSeal), and group 3 (Tisseel) at the various ischemic times was as follows: at 6 hours, 80%, 80%, and 80%, respectively; at 8 hours, 80%, 80%, 60%; at 10 hours, 60%, 33%, 40%; at 12 hours, 20%, 20%, 0%. The CIT50 for the Control, FloSeal, and Tisseel groups was 9.4, 9.0, and 7.0 hours, respectively. Conclusions: FloSeal, a thrombin-based hemostatic agent, and Tisseel, a fibrin glue, displayed no adverse effect on flap survival in this model.

KW - Fibrin glue

KW - FloSeal

KW - Free flap

KW - Ischemia

KW - Reconstruction

KW - Tisseel

UR - http://www.scopus.com/inward/record.url?scp=0842321046&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0842321046&partnerID=8YFLogxK

U2 - 10.1097/00005537-200402000-00023

DO - 10.1097/00005537-200402000-00023

M3 - Article

C2 - 14755208

AN - SCOPUS:0842321046

VL - 114

SP - 301

EP - 304

JO - Laryngoscope

JF - Laryngoscope

SN - 0023-852X

IS - 2

ER -