Four years' experience with fibrin sealant in thoracic and cardiovascular surgery.
A single-donor fibrin sealant system was used in 689 thoracic and cardiovascular surgical procedures over the 4-year period between April 1, 1985, and March 31, 1989. An excellent overall success rate (646/689, 94% effective) was achieved with specific applications, including reduction of leakage of air (29/33, 88% effective), blood (595/634, 94% effective), and fluid (14/14, 100% effective), as well as positioning of anatomical structures such as coronary bypass grafts (8/8, 100% effective). Application methods included use of spray bottles (477/497, 96% effective), syringes (165/186, 89% effective), and a Silastic cannula through the flexible fiber-optic bronchoscope (4/6, 67% effective). The system was used in a wide variety of cardiac, pulmonary, esophageal, and vascular procedures to seal staple lines, suture lines, anastomoses, conduits, fistulas, and raw surfaces. No complications with this single-donor system secondary to blood-borne disease have been documented. Overall infection occurred at a nominal rate (16/689, 2%). Thus, fibrin sealant has been a useful tool to control the leakage of air, blood, and fluid during a wide variety of thoracic and cardiovascular procedures and may be of benefit to other surgeons.
Matthew
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Department of Surgery, University of Virginia Health Sciences Center, Charlottesville 22908.
Spotnitz
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Kron
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Daniel
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TM
Tribble
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CG
Nolan
S P
SP
D000336:Aerosols; D000714:Anastomosis, Surgical; D006348:Cardiac Surgical Procedures; D002404:Catheterization; D001026:Coronary Artery Bypass; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage / Q000138:chemical synthesis / Q000627:therapeutic use*; D006330:Heart Defects, Congenital / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D012086:Reoperation; D013594:Syringes; D013903:Thoracic Surgery
D000336:Aerosols; D015718:Fibrin Tissue Adhesive