Promoting
tissue adhesion is of concern in almost all areas of surgery. Human
fibrin,
thrombin and
clotting factor XIII have important roles in the healing of
wounds and in
scar formation. The gluing material we use is a prefabricated
fibrinogen concentrate produced from pooled human blood plasma (
Tisseel Kit, Immuno), obtained from
plasmapheresis centers in Central Europe and the US. The gluing
solution averages 110 mg/ml of coagulable material. On applying a
thrombin solution (by dripping it onto the area),
fibrinogen coagulated in 8-10 seconds (quick coagulation) or 30-50 seconds (slow coagulation).
Fibrin glue is valuable in tissue synthesis and
tissue adhesion, particularly where conventional
suture methods would be difficult. We summarize results in 53 patients operated on between 1985-1993. The
Tisseel tissue adhesive system was used for coating and sealing during
tympanoplasty (18 patients), and for closure of perilymphatic
fistulas (18), chylous
fistulas (2), oral and pharyngeal
fistulas (3),
cerebrospinal fluid leaks (4),
facial nerve injury (1), and in split-thickness skin graft and local skin flap application in
hereditary hemorrhagic telangiectasia (7). Tissue glue is valuable in tissue repair and local hemostasis, facilitates the surgeon's work and may obviate more complicated
surgical procedures.