Fibrin sealants in clinical practice

Albala, David

doi:10.1016/s0967-2109(03)00065-6

Cited by 114 publications

(83 citation statements)

References 39 publications

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“…Blood bank-derived fibrin sealants, autologous and point-of-use prepared sealants may vary in their composition (fibrinogen and thrombin concentrations as well as the adjunction of antifibrinolytic agents) from one preparation to the next, and hence, be less predictable in their performance [32]. Because of such variation in the mechanical clot strength, the clotting rate, viscosity, adhesiveness and resistance to proteolysis, handling and application are difficult.…”

Section: Discussionmentioning

confidence: 99%

“…Ductal occlusion with neoprene or prolamine, both nonresorbable glues, used most often without anastomosis after pancreatoduodenectomy [39], has been abandoned because permanent occlusion induces pancreatic atrophy and complete loss of exocrine function [32]. The rational to use resorbable glues [6, 7, 26, 27, 40] was to limit the action of pancreatic proteases while waiting for the pancreatodigestive tract anastomosis or the pancreatic stump to heal after (proximal or distal, respectively) pancreatectomy.…”

Section: Critical Appraisal Of the Literaturementioning

confidence: 99%

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Use of Sealants in Pancreatic Surgery: Critical Appraisal of the Literature

et al. 2009

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Background/Aims: Fibrin sealants containing both fibrin and thrombin have been used to control bleeding, reinforce suture lines and enhance tissue healing. However, the literature provides contradictory results. Methods: A systematic literature search was performed to determine the use of fibrin sealants in pancreatic surgery. These articles were then critically appraised according to their methodologies, outcomes and conclusions. Results: Twenty-four studies were found, including 6 controlled randomized trials. Of these, 16 studies were analyzed. Many methodological flaws and lack of consistency in definitions were found, making comparisons between studies difficult if not impossible. Conclusion: Because of the heterogeneity and lack of high-level evidence, the current literature does not allow us any conclusion: neither is there proof that fibrin sealants are of any real utility in pancreatic surgery, nor that they do not work. Further large-scale controlled trials are necessary before concluding that they do or do not provide any advantages in pancreatic surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Critical Appraisal Of the Literaturementioning

confidence: 99%

Use of Sealants in Pancreatic Surgery: Critical Appraisal of the Literature

et al. 2009

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“…Fibrin sealants typically contain fibrinogen and thrombin, which are delivered simultaneously to a bleeding site to achieve hemostasis. 1 The hemostatic effectiveness and safety of fibrin sealants have been previously demonstrated in a wide variety of surgical procedures, spanning multiple surgical specialties. [2][3][4][5][6][7][8][9] Recent controversy surrounding the safety of an antifibrinolytic agent, aprotinin, has prompted review of its use.…”

Section: Introductionmentioning

confidence: 99%

A Randomized Trial of Aprotinin-Free Fibrin Sealant Versus Absorbable Hemostat

Fischer

Wood

Shen³

et al. 2011

Clin Appl Thromb Hemost

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Background: This study evaluated the safety and hemostatic effectiveness of a tranexamic acid-and aprotinin-free fibrin sealant versus an absorbable hemostat in soft tissue during elective retroperitoneal or intra-abdominal surgery. Materials and Methods: This randomized, active-controlled, multicenter study enrolled patients who were undergoing elective retroperitoneal or intra-abdominal surgery and required adjunctive hemostatic measures at the target bleeding site (TBS). Patients were randomized (time ¼ 0 minutes) to receive fibrin sealant or absorbable hemostat. The primary endpoint was the absence of bleeding at the TBS at 10 minutes. Secondary endpoints included the absence of bleeding at 4 and 7 minutes and the incidence of treatment failure (bleeding at 10 minutes or brisk bleeding requiring additional hemostatic measures), and the incidence of complications potentially related to bleeding. Adverse events were assessed. Results: Patients (N ¼ 124) were randomized to receive fibrin sealant (n ¼ 62) or absorbable hemostat (n ¼ 62). A higher percentage of patients who received fibrin sealant versus absorbable hemostat achieved hemostasis within 10 minutes (95.2% vs 82.3%; 95% CI, 1.02-1.35) and also at 4 (74.2% vs 54.8%; 95% CI, 1.04-1.80) and 7 (90.3% vs 77.4%; 95% CI, 1.00-1.39) minutes. A lower incidence of treatment failure was observed for patients receiving fibrin sealant. Similar incidences of adverse events and complications potentially related to bleeding were observed. Conclusions: This tranexamic acid-and aprotinin-free fibrin sealant is safe and effective for achieving hemostasis in soft tissue during elective retroperitoneal or intra-abdominal surgery.

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“…The most widely used methods for joining tissues focus on mechanical fasteners such as sutures and staples. Surgical adhesives, however, provide attractive alternatives to mechanical fastening (Strausberg and Link 1990, Albala 2003, Ninan et al 2003, Singer and Thode 2004. In addition to their rapid application, they are particularly usefiil in tissues which are difficult to reach, too difficult to cauterize or too delicate to withstand however, for which these adhesives cannot be used, e.g.…”

Section: Design Of Water-resistant Adhesivesmentioning

confidence: 99%

“…In addition to their rapid application, they are particularly usefiil in tissues which are difficult to reach, too difficult to cauterize or too delicate to withstand however, for which these adhesives cannot be used, e.g. in areas continuously bathed in body fluids (mucous membranes, bladder, etc) (Albala 2003, Ninan et al 2003, Singer and Thode 2004. Marine bioadhesives could be ideal candidates for such applications because they ftinction in aqueous environment, they possess the appropriate adhesive and cohesive properties, and they are ultimately biodegradable (Strausberg andLink 1990, Ninan et al 2003).…”

Section: Design Of Water-resistant Adhesivesmentioning

confidence: 99%

Echinoderm Adhesive Secretions: From Experimental Characterization to Biotechnological Applications

Flammang

Santos

Haesaerts

Progress in Molecular and Subcellular Biology

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Adhesion is a way of life in echinoderms. Indeed, all the species belonging to this phylum use adhesive secretions extensively for various vital fiinctions. According to the species or to the developmental stage considered, different adhesive systems may be recognized. (1) The tube feet or podia are organs involved in attachment to the substratum, locomotion, feeding or burrowing. Their temporary adhesion relies on a duo-gland adhesive system resorting to both adhesive and deadhesive secretions. (2) The larval adhesive organs allow temporary attachment of larvae during settlement and strong fixation during metamorphosis. (3) The Cuvierian tubules are sticky defence organs occurring in some holothuroid species. Their efiBcacy is based on the instantaneous release of a quick-setting adhesive. All these systems rely on diEferent types of adhesion and therefore differ in the way they operate, in their structure and in the composition of their adhesive. In addition to fimdamental interests in echinoderm bioadhesives, a substantial impetus behind imderstanding these adhesives are the potential technological applications that can be derived fi-om their knowledge. These applications cover two broad fields of applied research: design of water-resistant adhesives and development of new antifouling strategies. In this context, echinoderm adhesives could offer novel features or performance characteristics for biotechnological applications. For example, the rapidly attaching adhesive of Cuvierian tubules, the releasable adhesive of tube feet or the powerfijl adhesive of asteroid larvae could each be usefiil to address partictilar bioadhesion problems.

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Fibrin sealants in clinical practice

Cited by 114 publications

References 39 publications

Use of Sealants in Pancreatic Surgery: Critical Appraisal of the Literature

Use of Sealants in Pancreatic Surgery: Critical Appraisal of the Literature

A Randomized Trial of Aprotinin-Free Fibrin Sealant Versus Absorbable Hemostat

Echinoderm Adhesive Secretions: From Experimental Characterization to Biotechnological Applications

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