Fibrin sealant in wound repair: a systematic survey of the literature.
Fibrin sealants have recently been approved for clinical use in the US by the FDA and have been available for clinical use in Europe for years. The indication for use in the US is haemostasis. Nevertheless, both commercial and non-commercial fibrin sealant preparations are also for wound healing and for prevention of abdominal adhesions in the US and Europe. To the non-cognoscenti of fibrin sealants, their use to promote wound repair and to prevent abdominal adhesions appears contradictory since an agent that promotes connective tissue repair might be expected to promote abdominal adhesion rather than prevent them. In this systematic survey of the animal and clinical data evidence is presented that supports both off-label uses. However there is much inconsistency in the data secondary to the use of various fibrin sealant preparations, different animal models and clinical situations and different application techniques. It is clear from this survey that standard preparation and application of fibrin sealant for a particular surgical setting are needed to resolve the many apparent discrepancies in the literature. A corollary to this is the likelihood that different fibrin sealant preparations may be preferred for different clinical situations.
Clark
R A
RA
Department of Dermatology, SUNY at Stony Brook, Stony Brook, New York 11795-8165, USA. rafclark@epo.som.sunysb.edu
D000818:Animals; D004322:Drainage / Q000379:methods; D015718:Fibrin Tissue Adhesive / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D023421:Models, Animal; D016038:Skin Transplantation / Q000379:methods; D017695:Soft Tissue Injuries / Q000188:drug therapy; D013514:Surgical Procedures, Operative / Q000379:methods; D000267:Tissue Adhesions / Q000517:prevention & control; D014014:Tissue Adhesives / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology; D014947:Wounds and Injuries / Q000188:drug therapy*; D014950:Wounds, Penetrating / Q000188:drug therapy
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives