Tissue Adhesion with Highly Concentrated Human Fibrinogen in Otolaryngology

Abstract

This paper summarizes a tissue adhesive system consisting of highly concentrated human fibrinogen and thrombin. The addition of blood-clotting factor XIII stabilizes the adhesive system against fibrinolysis. Although the adhesion system cannot and should not replace surgical suture, it provides valuable assistance in tissue synthesis and in local hemostasis, particularly in cases where conventional suture methods are especially difficult to apply. In addition to good adhesion, an elastic consistency, and good tissue compatibility, the adhesive is completely absorbed and, therefore, preferable to conventional tissue adhesives based on cyanoacrylate. The system has been used successfully in split thickness skin graft application, myringoplasty, repair of dural defects, hemostasis after tonsillectomy, and achieving an airtight seal in tracheoplasty.

Autologous Fibrin Sealant Reduces Pain After Tonsillectomy

“…Its indications in otolaryngology include fixing fascia grafts in myringoplasty, sealing tympanic tears, sealing frontobasal injuries with dural rupture and frontobasal fistulas, and achieving hemostasis in tonsillectomy involving patients with coagulopathies. 23 …”

“…Its indications in otolaryngology include fixing fascia grafts in myringoplasty, sealing tympanic tears, sealing frontobasal injuries with dural rupture and frontobasal fistulas, and achieving hemostasis in tonsillectomy involving patients with coagulopathies. 23 There are both advantages and disadvantages to using fibrin sealant prepared from autologous blood, as opposed to commercially produced fibrin sealant. The advantage of using autologous fibrinogen is that this method eliminates the risk of viral disease transmission, which is very small but, nonetheless, present, with the commercial product, which is made from pooled plasma.…”

Design Strategies and Applications of Tissue Bioadhesives

“…This application demands sealants with specific flow and crosslinking characteristics to make them suitable for injection through lumen catheters and allow enough time for handling and injection 22. There are also numerous reports on the applications and performances of fibrin sealants in a variety of medical disciplines such as plastic surgery and skin grafts,30 ear, nose, and throat (ENT) and head and neck surgery,31 trauma surgery,32 urology,4, 22 and ophthalmology 33…”

An Evaluation of Fibrin Tissue Adhesive Concentration and Application Thickness on Skin Graft Survival

“…The individual fibrin monomers, in the presence of Factor XIII and calcium ions, undergo the process of cross‐linkage to form a stable, semi‐solid fibrin clot. 2–5 …”