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Autologous fibrin tissue adhesive in endoscopic sinus surgery.

Abstract
Endoscopic sinus surgery may be complicated by bleeding, formation of synechia, and infection. This study investigated the application of autologous fibrin tissue adhesive during endoscopic sinus surgery in an attempt to avoid packing, to decrease complications, and to improve healing. Fibrin tissue adhesive from pooled human blood is a hemostatic and bacteriostatic agent. Autologous fibrin tissue adhesive avoids the potential infectious and immunologic risks of the pooled blood product. Twelve patients undergoing bilateral endoscopic sinus surgery participated in the study. Phlebotomy and preparation of the adhesive were performed during the procedure. Fibrin tissue adhesive was applied to only one side, with the contralateral side used as a control. Bacitracin ointment was applied to the adhesive-treated side, and packing coated with bacitracin was placed on the contralateral side. Patients were observed for a minimum of 3 months, and results were documented with photographic and video recordings. A uniformly high degree of patient satisfaction was achieved because of the elimination of packing and a sensation of increased nasal airway patency on the fibrin-treated side. Fibrin tissue adhesive provided hemostasis, decreased crusting, accelerated mucosal healing, and diminished synechia. Autologous fibrin tissue adhesive is beneficial in endoscopic sinus surgery, and its application should be considered, especially when the risk of hemorrhage or synechia is increased.
AuthorsL L Gleich, E E Rebeiz, M M Pankratov, S M Shapshay
JournalOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (Otolaryngol Head Neck Surg) Vol. 112 Issue 2 Pg. 238-41 (Feb 1995) ISSN: 0194-5998 [Print] UNITED STATES
PMID7838545 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Infective Agents
  • Fibrin Tissue Adhesive
  • Hemostatics
  • Bacitracin
Topics
  • Adult
  • Anti-Infective Agents (therapeutic use)
  • Bacitracin (therapeutic use)
  • Endoscopy
  • Female
  • Fibrin Tissue Adhesive (chemistry, therapeutic use)
  • Follow-Up Studies
  • Hemostatics (therapeutic use)
  • Humans
  • Male
  • Middle Aged
  • Nose (pathology, surgery)
  • Paranasal Sinuses (pathology, surgery)
  • Patient Satisfaction
  • Postoperative Complications (prevention & control)
  • Pulmonary Ventilation (physiology)
  • Tissue Adhesions (prevention & control)
  • Wound Healing

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