Comparison of fibrin glue, N-butyl cyanoacrylate and conventional sutures for sealing bleeding at microvascular anastomotic sites

doi:10.19438/j.cjoms.2026.04.005

Abstract

Abstract: PURPOSE: To establish an animal model of blood leakage at microvascular anastomoses and evaluate the efficacy of fibrin glue (FG) and N-butyl cyanoacrylate (NBCA) in sealing anastomotic leakage. Additionally, to compare these methods with conventional suture repair in terms of operation time, patency rate, and inflammatory response. METHODS: Sixty healthy New Zealand white rabbits, weighing (2.8±0.2) kg with equal numbers of males and females were randomly divided into FG, NBCA and control groups (n=20 each). An end-to-end anastomosis model of the rabbit carotid artery with simulated anastomotic leakage was established. FG and NBCA were used to seal the leakage in the FG and NBCA group, while conventional suture repair was performed in the control group. Sealing time was recorded and vascular patency was evaluated immediately after surgery and at 4 weeks postoperatively. Perivascular tissues were harvested at 2 and 4 weeks for hematoxylin-eosin staining, and inflammatory response was evaluated using a semi-quantitative scoring system. RESULTS: The mean sealing times in the FG, NBCA and control groups were (87.80±22.02) s, (94.35±19.32) s and (245.70±59.41) s, respectively. The sealing times in the FG and NBCA groups were significantly shorter than that in the control group (P<0.05). No significant differences were observed in the immediate patency rate or the patency rate at 4 weeks postoperatively among the three groups (P>0.05). Histological analysis showed that inflammatory reactions around the anastomotic site were milder in the FG and NBCA group than in the control group and gradually decreased over time. CONCLUSIONS: Both FG and NBCA can effectively seal bleeding at the vascular anastomotic site. They provide advantages such as simple operation, rapid sealing and mild inflammatory response, while maintaining vascular patency comparable to conventional suturing techniques. Therefore, they may serve as safe and reliable adjuncts in microvascular anastomosis. FG may have certain advantages because of its good biocompatibility and complete biodegradability in vivo.

Key words: Microvascular anastomosis, Microsurgery, Fibrin glue, N-butyl cyanoacrylate, Leakage sealing

CLC Number:

R782
R615

Han Shaowei, Li Wenhao, Li Yahui, Zhao Xue, Chen Chuanjun. Comparison of fibrin glue, N-butyl cyanoacrylate and conventional sutures for sealing bleeding at microvascular anastomotic sites[J]. China Journal of Oral and Maxillofacial Surgery, 2026, 24(4): 348-352.

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