Fibrin glue for the treatment of persistent lymphatic drainage.
A 7-year-old girl underwent resection of an abdominal wall lymphangiomatous tumor. Postoperative serous drainage, up to 300 mL per day, developed despite application of external pressure to the wound. Thirty-three days after the initial procedure, fibrin glue was applied to the draining tract. Concentrated fibrinogen was prepared from one unit of blood donated by the patient's mother. Ten milliliters fibrinogen and 10 mL thrombin (1,000 U/mL) were injected simultaneously through the wound drain as it was slowly removed, and pressure was reapplied for 48 hours. No further drainage occurred, and at 2- and 14-week follow-up examinations the wound had healed normally without reaccumulation of fluid. Fibrin glue successfully sealed this persistently draining abdominal wall tract. It is a painless, safe, and effective biologic sealant, and when prepared from homologous plasma it carries a low risk of virus transmission.
Giberson
W G
WG
Section of Pediatric Surgery, Mayo Clinic, Rochester, MN.
McCarthy
P M
PM
Kaufman
B H
BH
D000009:Abdominal Muscles; D007611:Aprotinin / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D004338:Drug Combinations / Q000009:adverse effects / Q000627:therapeutic use; D005176:Factor XIII / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D015718:Fibrin Tissue Adhesive; D005340:Fibrinogen / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008196:Lymph; D008202:Lymphangioma / Q000601:surgery; D011183:Postoperative Complications / Q000473:pathology / Q000628:therapy*; D013917:Thrombin / Q000009:adverse effects / Q000627:therapeutic use*; D014945:Wound Healing
D004338:Drug Combinations; D015718:Fibrin Tissue Adhesive; D005340:Fibrinogen; D005176:Factor XIII; D007611:Aprotinin; D013917:Thrombin