Abstract
Tissue adhesive, TISSEEL, is composed of physiological substances; human fibrinogen, thrombin and coagulation factor XIII. For the purpose of the clinical application, experimental studies were performed in vivo to evaluate its strength as adhesive and other character. Experiment one : At first, rabbit's dura mater and fascia were fixed with TISSEEL in vitro and it was affirmed that adhesive strength became enough to seal not only cerebrospinal fluid pessure but arterial pressure 5 min after the application. Then using 20 rabbits, bone windows were made on head bilaterally and square dural pieces were cut off. At one side, dura plasty with TISSEEL was performed and at the another side, exposed arachnoid membrane was coated with TISSEEL. Histological changes were studied by one month later. Histological adhesion occurred between dura mater and leakage of cerebrospinal fluid did not occur. Brain cortex was intact under the arachnoid membrane coated with TISSEEL. Experiment two : Using 35 rats, right carotid artery (0.8-1.0 mm in diameter) and femoral vein (1.0-1.2 mm in diameter) were exposed. Following clamp at both proximal and distal ends, vessel was cut off. Then two stitches were put on and good adaptation of both edges was done, then coated with TISSEEL. Five minutes after in the case of artery and three minutes after in the case of vein, clamps were released. After 2 weeks, the adhesive allows the exact, flat adaptation of the wound edges and promoted flawless scar formation. This tissue adhesive on a physiologically basis has several advantageous character ; the area to be glued need not to be dry, it has elasticity, no hypertrophic tissue reaction, deniable neurotoxicity. TISSEEL can be applied in widely varying areas of neurological surgery.
