Role of Tisseel Fibrin Sealant on Postoperative Seroma and Hematoma Rates in Rhytidectomy Patients

Abstract

Introduction: Rhytidectomy has become a popular procedure for the surgical treatment of the aging face and facial rhytids. Advances in autogenous, allogenic, xenographic, and synthetic sealant and hemostatic agents, working on multiple locations of the clotting cascade, are used by various specialties. Tisseel, a fibrin sealant (Baxter Healthcare Corporation, Westlake Village, Calif), can be categorized as a hemostat and sealant agent. In the rhytidectomy literature, the use of the allogenic product Tisseel has been reported to lead to superior results with fewer complications when compared with traditional suturing techniques and meticulous intraoperative hemostasis. The ability of this fibrin sealant to reduce the rate of postoperative fluid collections, such as hematoma and seroma, is currently under investigation. Materials and Methods: We conducted a retrospective cohort study. Patients from 2 medical centers were divided into 2 groups. Group 1 served as the control, in which biplane rhytidectomy procedures were completed with no fibrin sealant. In group 2, the experimental group, the fibrin sealant agent was used during the rhytidectomy procedures. In the experimental group, all patients underwent a biplane rhytidectomy procedure with 2 mL of fibrin sealant applied directly under the surgical flap to the subcutaneous surfaces. The effect of each treatment on the postoperative rate of formation of seromas and hematomas was assessed and recorded within a 3-day period after the surgery. Results: The difference in the rate of postoperative seroma or hematoma development in the control group versus the experimental group was not found to be statistically significant. Conclusions: The use of fibrin sealant can complement good surgical hemostatic technique, but the material cannot be relied on to reduce postoperative rates of hematomas and seromas after rhytidectomy procedures.