Closure of Mucosal Defects Over Exposed Mandibular Plates Using Fibrin Glue

Abstract

Background: Mandibular plates may become exposed following radiation therapy, infection, and mucosal necrosis. This may lead to early removal of the mandibular plates with subsequent instability of bone fragments.Objective: To compare fibrin glue, a bioadhesive, with traditional sutures in closing mucosa over exposed mandibular plates in a cat.Design: Prospective matched-pairs analysis.Subjects: Nine cats were used, and each cat served as its own control.Intervention: Bilateral mandibular plates were fixed on the buccal side of the mandible of 9 cats. The surgical defects over the plates were left uncovered. After 4 days, the plates on the right side were covered with a mucosal graft fastened with fibrin glue, and on the left side the grafts were secured with sutures. After 10 days, the grafts were excised and a histological examination was performed. Results:The mean operative time for coverage was 2 minutes 11 seconds for the fibrin glue and 12 minutes 48 seconds for the sutures (PϽ.001). Gross examination revealed granulation or ulceration in 3 of the fibrin and 9 of the suture specimens (PϽ.005). All specimens displayed mild-to-moderate acute and chronic inflammation. All sutured specimens showed focal foreign bodytype giant cells surrounding fragments of bone and suture. Two mandibular plates were partially exposed on the fibrin glue side. Conclusions:The use of fibrin glue to cover exposed mandibular plates is safe and well tolerated in cats. Glue application requires a shorter operative time and is associated with fewer occurrences of granulation and ulceration when compared with suture fixation. Further studies are indicated to titrate the concentration of fibrin glue and to prevent plate exposure.

Paradoxical effects of elastase inhibitor guamerin on the tissue repair of two different wound models: sealed cutaneous and exposed tongue wounds

“…The cutaneous wound was not stitched and remained open but covered with excessive natural fibrin sealant that is further cross-linked to host tissue matrix as protective barrier for external microbial infiltration as well as accelerating the wound healing by its components of different growth factors (Gaboriau et al, 1999;Kjaergard et al, 1999;Bolliger-Stucki et al, 2000). In this model, a potent antiinflammatory effect of guamerin was observed in the semi-enclosed cutaneous wound, remained almost in an aseptic condition, until the 5th day of experiment.…”

Suture materials and biomaterials

“…It has been used extensively in human surgery, including maxillofacial surgery. 69 Similar to its xenogenous counterpart, autologous fibrin sealants may be used as a hemostatic, but also as an promoter of bone graft healing. 65,66 It is especially useful for closure of extraction wounds or following cyst enucleation in patients with coagulopathies.…”

Fibrin glue for intraperitoneal laparoscopic mesh fixation: a comparative study in a swine model

“…Extensive experimental data on laparoscopic inguinal hernia repair (IHR) have shown that the efficacy of fibrin glue as a means of mesh fixation is comparable to that of traditional techniques [1-3, 12, 15, 20, 25-27]. Fibrin glue causes a chemotactic attraction and stimulation of fibroblasts that result in enhanced tissue integration, achieving biologic soft fixation [28,29]. Prospective data also suggest that use of fibrin sealant significantly decreases pain and bleeding complications by avoiding the penetrating trauma and resultant neurovascular injury seen with sutures and tacks [12,15,16,20,27,30,31].…”