Human
Fibrin Glue (HFG) is made of two components contained in separate vials: a freeze dried concentrate of clotting
proteins, mainly
fibrinogen,
Factor XIII and
fibronectin (the sealant) and freeze dried
thrombin (the catalyst). The first component is reconstituted with an
aprotinin solution that inhibits tissue fibrinolysis. The second component (
thrombin), available in 500 I.U. concentration, is dissolved with
calcium chloride. It is so a set of substances involved in the
hemostatic process and in the wound healing, conferring to the product the following important properties:
hemostatic and sealing action, through the strengthening of the last step of the physiological coagulation; biostimulation, which favors the formation of new tissue matrix. The indications for the use of
human fibrin sealant are numerous and present in all the surgical branches. A randomized controlled trial of 50 patients undergoing
hernia repair according to Lichtenstein's technique under
local anesthesia was performed. Patients had concurrent coagulopathies as a consequence of
liver disease or long-term treatment with
anticoagulants for
ischemic heart disease or cardiac rhythm disturbances. Coagulopathies were defined according to the following criteria: prothrombin time < 10.5 seconds, activated partial thromboplastin time < 21 seconds, and
fibrinogen < 230 mg/dL. Patients were randomized in a 1:1 ratio with (group A) or without (control group B) use of human
fibrin glue: Postoperative hemorrhagic complications were significantly reduced in group A (4%) compared with group B (24%). This study showed that human
fibrin glue is effective in preventing local hemorrhagic complications after
inguinal hernia repair in patients with concurrent coagulation disorders.