Fibrin glue, also known as fibrin sealant, is a specialized medical product used in various surgical settings to support the body’s natural healing processes. It functions as a biological adhesive and a hemostatic agent, helping to stop bleeding and seal tissues together. This product is effective in promoting tissue repair and stability by mimicking the body’s natural clotting process.
Understanding Fibrin Glue
Fibrin glue is a surgical adhesive derived from human blood components, specifically designed to aid in tissue repair and bleeding control. It consists of two primary components: fibrinogen, a protein found in blood plasma, and thrombin, an enzyme central to blood clotting.
The Mechanism Behind Fibrin Glue
The scientific basis of fibrin glue’s function lies in its ability to replicate the final steps of the body’s blood coagulation cascade. The glue is typically supplied as two separate solutions: one containing concentrated fibrinogen and Factor XIII, and the other containing thrombin, often with calcium chloride. These components are mixed together at the point of application, initiating a rapid biochemical reaction.
Upon mixing, thrombin acts on fibrinogen, causing it to split into fibrin monomers. These monomers then spontaneously link together, or polymerize, to form long, insoluble fibrin strands.
Concurrently, thrombin activates Factor XIII into Factor XIIIa, which forms strong cross-links between the fibrin strands. This creates a stable, three-dimensional fibrin clot or gel that adheres to surrounding tissues, providing a physical barrier that stops bleeding and seals tissue surfaces.
Where Fibrin Glue is Used
Fibrin glue offers a wide range of medical and surgical applications due to its ability to promote hemostasis and tissue sealing. It is commonly employed to control bleeding during various surgical procedures, particularly where traditional methods are difficult or ineffective. This includes complex operations such as liver surgery and procedures involving solid organs where diffuse bleeding can occur.
Beyond controlling bleeding, fibrin glue is also used to seal air or fluid leaks, beneficial in lung surgery to prevent air leaks or in vascular surgery to reinforce vessel repairs. It can be used in neurosurgery to prevent cerebrospinal fluid leaks, in ophthalmic procedures like “no sutures” corneal transplantation, and in skin grafting to secure grafts and reduce post-operative pain. It also finds use in dental procedures, nerve repair, and for sealing fistulas.
Considerations for Use
While fibrin glue is generally considered safe and effective, medical professionals consider several factors before its application. The product is derived from human plasma, and although processed to minimize risks, there remains a theoretical, very low risk of transmitting viral infections. Modern manufacturing processes, including donor screening and viral inactivation steps, significantly reduce this concern.
Potential side effects are rare but can include allergic reactions, such as hives or itching. More severe systemic responses are very uncommon.
Proper application technique is important; for example, if applied with a spray device, incorrect pressure settings could lead to air or gas entering tissues, which can have serious consequences.
Fibrin glue is designed to be biocompatible, meaning it is well-tolerated by the body. It is also biodegradable, gradually breaking down as the wound heals naturally over time, typically within 10 to 14 days.