Nurses�fInformation Center

Fibrin sealants (also known as tissue adhesives or glues) are designed to mimic the final steps of the blood coagulation cascade, forming a stable, physiological fibrin clot that assists hemostasis and wound healing.

Fibrin sealants are derived mainly from blood plasma and contain necessarily fibrinogen and thrombin. Further ingredients are anti-fibrinolytic agent (such as aprotinin), and calcium chloride. Some fibrin sealants also contain factor XIII.

Fibrin clots formed from fibrin sealants are similar to normal blood clots and after a few weeks are naturally degraded by the body's enzymes.

Fibrin sealants are used mainly for topical hemostasis, suture support and tissue adhesion. They are used:

• to assist hemostasis in a bleeding field
• to reduce blood flow from solid organs
• to help seal suture holes
• to help seal anastomosis or leaks from hollow organs
• to assist or replace sutures in surgical procedures, particularly where suturing is difficult or impossible.

New and novel uses for fibrin sealant are still being developed; some of the more recent uses include tissue engineering and drug delivery.

The idea of promoting hemostasis using fibrin was first reported over 90 years ago. Fibrin sealants, as we know them today, have been available in some countries for over 20 years and they are generally well tolerated by patients. Because fibrin sealants contain human plasma products, currently available commercial fibrin sealants undergo a number of key purification steps designed to ensure that the risk of transmitting an infectious disease is as low as possible.

Manufacturers test for different virus markers. As a result of these safety processes, commercial fibrin sealants are considered safer than blood transfusion.¹

Reference

1. Schreiber GB, Busch MP, Kleinman SH, Korelitz JJ. The risk of transfusion-transmitted viral infections. N Engl J Med 1996;334:1685-1690