Clinical Application of GRF Glue Adhesive in Liver Surgery

Masanori Suzuki, Tetsuyuki Uchiyama, Masaya Oikawa, Shinichi Takemura and Seiki Matsuno

First Department of Surgery, Tohoku University School of Medicine

A biological adhesive, GRF glue, prepared by combining gelatin, resorcinol, and formaldehyde, was applied to the cut surface of a rat liver to determine the glue's effects histologically. The adhesive force of GRF glue was also compared to a fibrin glue in a tensile strength test. Male Sprague-Dawley rats, weighing 200 to 250 g, were subjected to partial hepatectomy, and the GRF glue was applied to the cut surface of the liver. In this animal model, the process of GRF glue absorption was followed histologically. The surface of the eosinophilic glue was first covered by fibrous tissue that extended from the adjacent normal tissue. Then, macrophages appeared within the glue and the absorptive process continued. On day 28 following the glue application, tissue repair was generally completed with a thick fibrous layer replacing the cut region. On the intact liver surface, on the other hand, fibrosis or fatty degeneration was noted, and indicated direct hepatic toxicity of the formaldehyde. In an experiment using lumps of GRF glue placed in the peritoneal cavity, 100%survival was recorded at a dosage of 2.5 mg/g per body weight. When the dosage exceeded 10 mg, however, all animals succumbed within 5 days of exposure. The above experiments contribute to clarifying the efficacy and absorptive process of GRF glue when applied to the hepatectomized liver surface. The tissue toxicity of formaldehyde or substances that are generated during the reabsorption process was confirmed when the glue was applied inappropriately or at excessive dosages. It is essential to closely observe the method of application and the dosage of this agent to prevent its potential adverse effects.

Key words
GRF glue, tissue adhesives, liver surgery

Reprint requests
Masanori Suzuki First Department of Surgery, Tohoku University School of Medicine 1-1 Seiryumachi, Aoba-ku, Sendai, 980-8574 JAPAN

Accepted
September 22, 1999

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