title: Fibrin glue as a protective tool for microanastomoses in limb reconstructive surgery.
abstract: OBJECTIVE
  Fibrin glue becomes a more and more routinely used tool for stabilization of microanastomoses and nerve repair. This paper summarizes the technical properties and advantages of its use in a wide variety of microsurgical contexts, and includes an exemplary limb reconstructive case.
  
  
  METHODS
  A total of 131 patients who had undergone elective and emergency microsurgery mainly of the limbs were retrospectively analyzed, as was the use of free flaps.
  
  
  RESULTS
  The use of fibrin glue allows for proper positioning of anastomoses and repaired nerves. No torsion of the pedicle could be seen. The flap survival rated >94%. The fibrin glue could stay in place in >99%. In the rare case of revision, the fibrin glue could easily be removed without damaging the region of the microanastomosis.
  
  
  CONCLUSIONS
  Fibrin glue should not be used to repair insufficient, i.e., leaking anastomoses, but it does protect the site of anastomosis from tissue and fluid pressure. It prevents the pedickle from torsion and its use facilitates relocation of the microanastomoses in cases of revision surgery.
authors.affiliation: Department of Plastic, Esthetic and Special Hand Surgery, University Hospital Leipzig, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Langer
authors.affiliation: Department of Trauma, University Hospital Bergmannsheil, Ruhr University Bochum, Germany.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Schildhauer
authors.affiliation: Department of Trauma, University Hospital Bergmannsheil, Ruhr University Bochum, Germany.
authors.forename: Marcel
authors.initials: M
authors.lastname: Dudda
authors.affiliation: Department of Plastic, Esthetic and Special Hand Surgery, University Hospital Leipzig, Germany.
authors.forename: Jeannine
authors.initials: J
authors.lastname: Sauber
authors.affiliation: Department of Plastic, Esthetic and Special Hand Surgery, University Hospital Leipzig, Germany.
authors.forename: Nick
authors.initials: N
authors.lastname: Spindler
keywords: fibrin glue; free flap; microanastomosis; microsurgery; nerve reconstruction