Fibrinogen-impregnated collagen as a combined haemostatic agent and antibiotic delivery system in a porcine model of splenic trauma

Abstract

Objective: To assess the effect of rifampicin on the haemostatic function of a fibrinogen-impregnated collagen fleece. Design: Laboratory experiment. Setting: Government research establishment, UK. Material: Six Large White pigs. Interventions: Four 5 cm incisions were made in the spleen of each animal. Three of the wounds were each covered with a sheet of either dry, saline-soaked or rifampicin-soaked fibrinogen-impregnated collagen. Main Outcome Measures: The bleeding time and blood loss from each wound was recorded. Systemic serum rifampicin concentrations were measured using a Staphylococcus aureus inhibition assay. Results: Dry fibrinogen-impregnated collagen resulted in significantly less blood loss (112 (21) compared with 39 (13)ml, p < 0.05) and shorter bleeding time (16 (2) compared with 9 (1) min, p < 0.01) than in untreated control wounds. Pre-soaking in saline or rifampicin solution had no significant effect on its haemostatic function. Rifampicin concentrations above the minimum inhibitory concentration were recorded in the systemic circulation 45 minutes after injury and persisted for the duration of the experiment. Conclusions: Fibrinogen-impregnated collagen is an effective haemostatic agent in splenic trauma that may be of use for both the local and systemic delivery of antibiotics.