Effect of Fibrin Glue on Collagen Deposition after Autologous Fascia Grafting in Rabbit Vocal Folds

Abstract

Application of FG altered collagen deposition around the fascia grafts, leading to significantly increased collagen density after 90 days. Differences found in the composition of the extracellular matrix in later stages of the healing process are a result of changes that occur in the beginning of this process. Therapeutic interventions, such as the use of FG and/or its components, performed in the early stages of wound healing may interfere with the complex interactions of fibroblasts, inflammatory cells, and cytokines (especially TGF-beta), thereby modulating the healing process.

Histologic comparison of vocal fold microflap healing with sutures and glue

“…In the present study, best results regarding lamina propria collagen concentration were seen in vocal folds left to heal by second intention. Other authors have in fact reported higher levels of collagen following the use of fibrin glue in microflaps both in canine, rabbits, and porcine. The only animal study to report the use of microsutures in vocal fold microflaps was Fleming et al These authors used a canine animal model and reported a larger average cross‐sectional scar area when microflaps were not sutured 6 weeks after interventions.…”

The Effect of Fibroblast Growth Factors in Grafted Fascia into the Vocal Fold of Rabbits

“…Secondly, in vitro studies showed that the FGFs led to an increased production of type I collagen and hyaluronic acid. 5 28 Yet, Scapini et al 29 demonstrated that their therapeutic interventions in an animal model of rabbits statistically increased the density of collagen around the graft. However, Akdogan et al 23 found significant difference in a group of vocal folds from rabbits treated with vitamin A compared with an untreated group (lesser deposition of collagen and fibroblasts in the first group); and Krishna et al, 25 studying in vitro and in vivo vocal fold scar model of rabbits with hepatocyte growth factor exposure, found a decreased collagen secretion by fibroblasts.…”

Comparison of tensile strength of fibrin glue and suture in microflap closure

“…Because this was an ex vivo study, histologic examination of the vocal fold at various points during the healing process was not able to be performed. Several reports examining scar formation in vocal fold defects reapproximated with fibrin glue show increased collagen when compared to secondary intention . This scar formation is hypothesized to be a result of increased inflammation from the glue, interference with the normal cytokine cell signaling process controlling wound healing, or an immune reaction secondary to the human products, although further study is necessary to understand this better.…”

“…Wound healing inside the glottis is further affected by the continued stress placed on the vocal folds by deglutition and respiratory tasks, as well as any phonotrauma that may be sustained during vocalization . Although previous reports have examined the histology of vocal fold wound healing with both fibrin glue and suture, the tensile strength of these closure methods has not been reported …”