Reduction of Perioperative Hemorrhage by Anterior Mediastinal Spray Application of Fibrin Glue during Cardiac Operations

Spotnitz, William D.; Dalton, Michelle; Baker, Joseph W.; Nolan, Stanton P.

doi:10.1016/s0003-4975(10)62115-7

Cited by 69 publications

(25 citation statements)

References 15 publications

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“…Reduction of bleeding by anterior mediastinal spray application of fibrin sealant during cardiac operations Spotnitz [24] found a significant reduction of perioperarive hemorrhage by anterior spray application of FS during cardiac operations. In 20 consecutively treated patients, FS was sprayed on the anterior mediastinum before closure of the median sternotomy incision_ A control group of 20 patients undergoing identical cardiac operations (CABG and valve replacements including one reoperative procedure) by the same surgeon within a 1 -year period was chosen for comparison of chest tube outputs.…”

Section: Fibrin Sealantmentioning

confidence: 99%

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Controlled clinical studies of fibrin sealant in cardiothoracic surgery — a review

Kjærgård¹,

Fairbrother²

1996

European Journal of Cardio-Thoracic Surgery

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Objective. More than 2300 clinical papers have been published on the surgical applications of fibrin sealant (FS), with the largest number in the speciality of cardiothoracic surgery. The purpose of this review of the literature was to find and evaluate controlled studies published in the field of cardiothoracic surgery, to clarify the indications and emphasize the benefits of FS available to the practising surgeon. Methods.A database of the surgical publications of FS was created. Up to the end of 1995, at least 24 controlled clinical studies had been published; these may be divided into 20 studies with a positive outcome and 4 studies where the results were not different from the controls. In none of the studies was the clinical result worse after the use of FS.Results. In most of the cardiac studies, FS was successfully used at bleeding sites in reoperations and in congenital heart surgery. Postoperative bleeding may also be reduced by the anterior mediastinal spray application of FS or by preparing woven Dacron prostheses with the sealant. In addition, FS has been found to improve results after type A aortic dissections and, by adding an antibiotic to the sealant, the postoperative infection rate for active endocarditis of the aortic root can be reduced. In pulmonary surgery FS can be used to reduce pulmonary air leakage, however the results of some studies diverge due to different clinical test conditions and the inclusion of only a small number of patients in the "negative" studies. In none of the controlled studies of esophageal surgery could FS prevent leakage from esophageal anastomoses_ Conclusions. Fibrin sealant is safewhen it is applied properly, but there is a learning curve for surgeons who start using it. An autologous sealant or a sealant containing human instead of bovine thrombin is preferred, since repeated use of bovine thrombin may induce coagulopathies. The number of controlled clinical studies of FS is currently increasing, with the majority of the papers revealing a beneficial effect of FS when it is used as a hemostatic or sealing agent in cardiothoracic surgery. [Eur J Cardio-thorac Surg (1996) 10:727-733]

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Section: Fibrin Sealantmentioning

confidence: 99%

“…Almost all of the investigators used 500 units/ml thrombin and 3000 KIU/ml of aprotinin. Only 1 out of 24 controlled studies [24] utilized single-donor cryoprecipitate to prepare the FS. No serious adverse drug events related to fibrin sealing were reported.…”

Section: Fibrin Sealantmentioning

confidence: 99%

Controlled clinical studies of fibrin sealant in cardiothoracic surgery — a review

Kjærgård¹,

Fairbrother²

1996

European Journal of Cardio-Thoracic Surgery

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“…These sealants have been used in cardiothoracic, vascular, and gastrointestinal surgery. A number of studies have shown that suture support with fibrin sealants is effective in reducing the volume of blood loss and the time to hemostasis in cardiovascular surgery [2,10,11,13,19,24]. More debated is the role of fibrin glue as a sealant for leaking gastrointestinal anastomoses.…”

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confidence: 99%

Sealing effect of fibrin glue on the healing of gastrointestinal anastomoses: implications for the endoscopic treatment of leaks

et al. 2004

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“…Wound healing is enhanced with fibrin glue and increased tensile strength has been noted [7]. It has achieved clotting in patients 271 with coagulopathies due to massive transfusions, chronic diseases, and inflammatory conditions [8,13]. Family members can act as directed donors to provide a safe source of fibrinogen in either elective or emergency situations.…”

Section: Discussionmentioning

confidence: 99%

Minimal suture blepharoplasty: Closure of incisions with autologous fibrin glue

Mandel¹

1992

Aesth. Plast. Surg.

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Blepharoplasty incisions can be cloned safely with autologous fibrin glue. The fibrinogen, prepared either from a whole-blood or plasmapheresis source, is mixed with commercially available thrombin to form a seal that is both hemostatic and adhesive. The complication rate is low and primarily due to technical factors in the initial cases. When compared with standard suture techniques, the incidence of minor problems such as milia formation was much lower. In select cases, the technique of using fibrin glue and a minimal number of sutures may be useful as an alternative method of wound closure in blepharoplasty patients.

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Reduction of Perioperative Hemorrhage by Anterior Mediastinal Spray Application of Fibrin Glue during Cardiac Operations

Cited by 69 publications

References 15 publications

Controlled clinical studies of fibrin sealant in cardiothoracic surgery — a review

Controlled clinical studies of fibrin sealant in cardiothoracic surgery — a review

Sealing effect of fibrin glue on the healing of gastrointestinal anastomoses: implications for the endoscopic treatment of leaks

Minimal suture blepharoplasty: Closure of incisions with autologous fibrin glue

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