Fibrin glue

The adhesive material is in bulk and also described as a wad because it is not a thin-bead type of adhesive, but rather a bulky and thick application that absorbs into the body over a period of time. 

In addition to the standard fibrin cements derived from natural fibrogen, there is also a product manufactured by AuraZyme Pharmaceuticals referred to as FIBRX pho- 

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Padybidri, A.N., Brown, E. and Kononov, V, Fibrin glue-assisted end-io-side anastomosis of rat femoral vessels Comparison with conventional suture method. Ann. Plasi. Surg., 34, 41-47 (1996). 

Spotnitz, W.D., Dalton, M.S., Baker, J.W. and Nolan, S.P, Reduction of perioperative hemorrhage by anterior mediastinal spray application of fibrin glue during cardiac operations. Ann. Thorac. Surg., 44, 529-531 (1987). 

Spotnitz, W.D., Mintz, PD., Avery, N., Bithell, T.C., Kaul, S. and Nolan, S.P, Fibrin glue from stored human plasma An inexpensive and efficient method for local blood bank preparation. Am. Surg., 53, 460-464 (1987). 

Daniels, T.M. and Fisher et al., PK., Antibodies to bovine thrombin and coagulation factor V associated with the use of topical bovine thrombin or fibrin glue a frequent finding. Blood, 82, 59a (1993). 

Currie LJ, Martin R, Sharpe JR, James SE (2003) A comparison of keratinocyte cell sprays with and without fibrin glue. Bums 29(7) 677-685... 

The use of adsorbent chemicals, such as zeolites and other haemostatic agents, to seal severe injuries quickly. Thrombin and fibrin glue are used surgically to treat bleeding and to thrombose aneurysms. 

Atrah H11994 Fibrin glue. British Medical Journal... 

Datta, D., Vlavianos, R, Alisa, A., Westaby, D. Use of fibrin glue (Beriplast) in the management of bleeding gastric varices. Endoscopy 2003 35 675-678... 

An aphylactic reaction has been described after the use of fibrin glue as a sealant after mastectomy, probably due to the presence of bovine aprotinin (24). 

All the components of fibrin glue are subjected to virucidal treatment (solvent/detergent treatment for fibrinogen and nanofiltration for thrombin). 

Fibrin glue has been widely used to treat anal fistulae. In a systematic review of 19 studies the reported success rates ranged from 0 to 100%, which may have been due to differences in patient selection (including fistula aetiology and type), treatment protocols, and follow-up duration (8). 

Fibrin glue has also been used experimentally to deliver a high concentration of drug to a local site, as in the example of the use of losartan to prevent neointimal hyperplasia in pig saphenous artery (10). 

The use of bovine fibrin glue in neurosurgery was associated with fatal neurotoxicity if the glue came into contact with the cerebrospinal fluid or dura (11,12) this has not been reported with fibrin glue of human origin. 

In three patients who underwent cardiovascular surgery subsequent abnormalities in hemostasis, characterized by increased activated partial thromboplastin time, prothrombin time, and bovine thrombin time, and by a markedly reduced concentration of factor V, developed between the seventh and eighth postoperative days after exposure to fibrin glue containing bovine thrombin (13). It was suggested that the glue also contains small amounts of factor V and that this may have caused the abnormalities. 

The use of preparations of fibrin glue containing bovine thrombin resulted in the development of antibovine thrombin antibodies. In a prospective study, 13 of 34 patients developed a thrombin inhibitor and reduced factor V activity (15,16). In another study a factor V inhibitor developed after cardiac surgery (17). 

Severe hypotension has been reported after the use of bovine fibrin glue for hemostasis in hepatic injury (18). In one there was cardiac arrest and death. These effects may have been the result of an anaphylactic reaction to one or more components of the glue. Of the three ingredients used to prepare fibrin glue, cryoprecipitate and bovine thrombin are antigenic and potentially the most likely causes of anaphylaxis. 

Canonico S. The use of human fibrin glue in the surgical operations. Acta Biomed Ateneo Parmense 2003 74(Suppl 2) 21-5. 

Kram HB, Reuben BI, Fleming AW, Shoemaker WC. Use of fibrin glue in hepatic trauma. J Trauma 1988 28(8) 1195-201. 

Hammond TM, Grahn MF, Lunniss PJ. Fibrin glue in the management of anal fistulae. Colorectal Dis 2004 6(5) 308-19. 

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