Fibrin Sealant In Prevention Research Articles

Comparative study between using of quilting sutures vs. using of fibrin sealant in prevention of seroma after abdominoplasty

Abstract Background Abdominoplasty is one of the most common body-contouring procedures. It is among the top five procedures in aesthetic surgery. The aim of abdominoplasty is to remove excess fat and skin and restore weakened muscles to create smoother firmer abdominal figure Aim of study The aim of the present study is to compare between the rate of seroma in patients undergone abdominoplasty using quilting sutures technique and patients undergone abdominoplasty using fibrin glue. Patients and Methods This study was conducted on 20 patients complaining of variable degrees of abdominal wall laxity seeking for surgical repair of abdominal wall, conducted from april 2019 till october 2019.on patients admitted at ain shams university hospitals and cairo university hospitals Results This study includes twenty patients with abdominal wall redundancy presented to Ain-Shams university hospital and kasr AL Ainy university hospital in the period (April 2019 - October 2019). The patients were divided into two groups: group A ten patients undergone abdominoplasty with quilting sutures technique, group B ten patients undergone abdominoplasty with fibrin glue. All 20 patients were females aging between 25 and 50 and with BMI between 25 and 30. Conclusion Within the limitations of our study we have concluded that this study adds to the mounting evidence that placement of quilting sutures or the application of fibrin glue is safe and effective and will contribute to a decrease in the seroma rate, the total amount of drain output, the time of drain removal and complications. It produces a safe and less eventful postoperative period.

Evaluation of Fibrin Sealant in Prevention of Cervical Anastomotic Leakage After McKeown Esophagectomy: A Single-Center, Retrospective Study.

Anastomotic leakage remains an issue after esophagectomy for patients with esophageal or esophagogastric junction cancer. Previous studies have indicated that the intraoperative application of fibrin sealant may reduce the incidence of postoperative anastomotic leakage. This retrospective study was aimed to evaluate the efficacy and safety of fibrin sealant in the prevention of anastomotic leakage in patients undergoing McKeown esophagectomy. We designed a single-center, retrospective study. Between January 2018 and December 2019, 227 patients with esophageal or esophagogastric junction cancer undergoing McKeown esophagectomy performed by our team were retrospectively identified, of whom 86 patients were included in the FS group and 141 patients were included in the control group. Intraoperatively, 2.5 ml of porcine fibrin sealant was applied circumferentially to the cervical anastomosis after the anastomosis was created in the FS group. The primary outcome was the incidence of cervical anastomotic leakage within the first three months after surgery. The differences in baseline clinical characteristics between the two groups were not significant except for a history of drinking. In the FS group, the postoperative cervical anastomotic leakage rate was lower (FS group: 4.7% [4 of 82] vs. control group: 19.9% [28 of 141], p < 0.01). Multivariate logistic regression showed that the intraoperative application of fibrin sealant was an independent protective factor for anastomotic leakage (OR 0.169, 95% CI 0.055-0.515, p=0.002). The intraoperative application of fibrin sealant could possibly prevent cervical anastomotic leakage after McKeown esophagectomy with satisfactory safety. Further prospective clinical trials are warranted.

Fibrin Sealant for Prevention of Resection Surface-related Complications After Liver Resection in Living Liver Donors

Fibrin Sealant for Prevention of Resection Surface-related Complications After Liver Resection in Living Liver Donors

Use of fibrin sealant in prevention of hanging palate: A rare complication after cleft palate surgery

Dehiscence of the mucoperiosteal flap from the alveolar margin is one of the rare complications reported after cleft palate surgery. This situation has been termed a hanging palate. [1] In these cases, secondary suturing is bound to fail. Intraoperative use of adhesives can obviate this problem. Although the adhesion system cannot and should not replace surgical suture, it provides valuable assistance in tissue synthesis and in local hemostasis at the time of primary surgery, particularly in cases where conventional suture methods are difficult to apply. In addition to good adhesion and good tissue compatibility, the adhesive is completely absorbed. This paper emphasizes on the effectiveness of the fibrin glue for the prevention of such a complication.

The Efficacy of Fibrin Sealant in Prevention of Anastomotic Leak After Laparoscopic Gastric Bypass

The Efficacy of Fibrin Sealant in Prevention of Anastomotic Leak After Laparoscopic Gastric Bypass

The efficacy of fibrin sealant in prevention of anastomotic leak after laparoscopic gastric bypass 1,2

Anastomotic leak after laparoscopic gastric bypass (GBP) can result in significant morbidity, mortality, and consumption of healthcare resources. Fibrin sealant has been used clinically in the prevention of leak; however, its efficacy has not been clearly demonstrated. The aims of this study were to (1) develop an iatrogenic leak model in swine, (2) examine the efficacy of fibrin sealant in sealing iatrogenic anastomotic leak, and (3) review our experience with the use of fibrin sealant in 66 patients who underwent laparoscopic GBP. This study was performed in three phases. In phase 1, laparoscopic gastrojejunostomy was performed in adult swine with iatrogenic disruption of the anastomotic staple line. The size of disruption was sequentially increased (6- to 12-F opening) until a leak model was developed. In phase 2, 16 animals underwent laparoscopic gastrojejunostomy with a 12-F disruption of the anastomosis; 10 animals (study group) had fibrin sealant (Tisseel VH) applied on the disrupted anastomosis and 6 animals (control group) did not receive fibrin sealant. Animals were sacrificed on postoperative day 5 or earlier if peritonitis developed and were examined for sealing of the anastomotic disruption and the presence of intraabdominal abscess. In phase 3, the outcome of 66 consecutive patients who underwent laparoscopic GBP with fibrin sealant applied at the gastrojejunostomy was reviewed. In phase 1, an anastomotic leak model was developed with a 12-F disruption of the staple line. In phase 2, two control animals required early sacrifice for bile peritonitis; three control animals had intraabdominal abscess discovered at sacrifice and one animal did not have any evidence of intraabdominal abscess or leak. Of the 10 animals in the study group, all survived until sacrifice and none of these animals had evidence of intraabdominal abscess or persistent leak. Therefore, 83% of animals in the control group developed either leak or abscess compared to 0% in the study group (P < 0.01, Fisher's exact test). Clinically, no leak or intraabdominal abscess developed in 66 patients who underwent laparoscopic GBP with the use of fibrin sealant. An anastomotic leak model was developed in swine with disruption of the stapled gastrojejunostomy to a 12-F opening. The use of fibrin sealant significantly reduces leak and abscess complication. Our results support the tissue sealing property of fibrin sealant and its use on high-risk gastrointestinal anastomosis.

The efficacy of fibrin sealant in prevention of gastrointestinal anastomotic leak

Introduction: Anastomotic leak, although low in frequency (1–2%), is a dreaded complication after Roux-en-Y gastric bypass (GBP). Clinical uses of fibrin sealant for prevention of gastrointestinal (GI) leak have been reported; however, its efficacy has not been demonstrated. The aims of this study were to 1) develop an anastomotic leak animal model, 2) examine the efficacy of the tissue sealing property of fibrin sealant, and 3) review our experience in the use of fibrin sealant in 42 patients who underwent laparoscopic GBP. Methods: This study was performed in three phases. In phase 1, laparoscopic GI anastomosis was performed in adult swine with disruption of the staple-line starting at a 6F opening and sequentially increased in size until a leak model was developed. A leak model was developed at a 12F opening. In phase 2, ten animals (study group) underwent laparoscopic gastrojejunostomy with a 12F disruption of the anastomosis and received 2-mL of fibrin sealant (Tisseel, Baxter Healthcare Corp) applied on the disrupted area. The control animals (n = 6) did not receive the fibrin sealant. Animals were sacrificed on postoperative day 5 or earlier if peritonitis developed. The primary endpoint was sealing of the disrupted anastomosis at sacrifice and secondary endpoint was evaluation for the presence of intraabdominal abscess. In phase 3, fibrin sealant was used clinically in 42 laparoscopic GBP patients. Results: In phase 2, persistent anastomotic leak was identified in 2 of 6 control animals (both required early sacrifice due to peritonitis). Three of 6 control animals had intraabdominal abscess discovered at sacrifice on postoperative day 5 without persistent leak and 1 animal in the control group did not have any evidence of intraabdominal abscess or leak. Of the 10 animals in the study group, all survived until sacrifice. None of the animals had evidence of intraabdominal abscess or persistent leak at sacrifice. Leak or abscess occurred in 83% of control animals compared to 0% in the study animals (p < 0.01, Fischer’s Exact test). Clinically, there was no leak or intraabdominal abscess in the 42 patients who underwent laparoscopic GBP. Conclusions: The use of fibrin sealant in an animal leak model significantly reduces leak and abscess complication. Our results support the efficacy of tissue sealing property of fibrin sealant and its use on high-risk GI anastomosis.

Fibrin sealant in prevention of flexor tendon adhesions: An experimental study in the rabbit

The effect of fibrin sealant on the development of adhesions in flexor tendon surgery was studied in both immobilized and active weight-bearing paws of rabbits. A partial laceration was produced and was treated with sutures alone or with both sutures and glue. Immobilized tendons treated in these ways showed no difference in adhesion formation, but in mobile tendons there was a difference at 6 weeks in gross appearance, scanning electron micrographic appearance, and strength of adhesions as measured when the distally cut tendon was pulled out of its sheath. These observations indicate that, after repair, a mobile flexor tendon heals with a smooth gliding surface and without formation of restricting adhesions when treated with fibrin glue around the suture site.