Fibrin sealants in surgical or traumatic hemorrhage

Abstract

Fibrin sealants have been used to control surgical hemorrhage for three decades, and numerous articles have reported their use in a variety of surgical procedures in both animal models and humans. This article reviews the recent literature on fibrin sealants with the specific aim of highlighting the use of fibrin sealants in planned and simulated trauma to provide background for clinicians who may consider using fibrin sealants in specific cases. An overview of the mechanisms of action of fibrin sealants, their indications, and current commercial formulations is also provided. Recent studies have evaluated the use of fibrin sealants in vascular surgery, including aortic anastomosis in an animal model, gastrointestinal anastomoses, plastic surgery, urologic procedures including heminephrectomy, and other procedures. Fibrin sealants continue to be used and evaluated in animal models and surgery. Their use in military settings and in civilian trauma centers, explored for several years, is not reported extensively in the literature. Recent events and the current tempo of military operations dictate that many potential scenarios exist for using fibrin sealants to control traumatic hemorrhage.