|Trade names||Artiss, Evicel, Tisseel, others|
|AHFS/Drugs.com||Professional Drug Facts|
Fibrin glue (also called fibrin sealant) is a surgical formulation used to create a fibrin clot for hemostasis or wound healing. It contains separately packaged human fibrinogen and human thrombin.
It is also used for repairing dura mater tears and bronchial fistulas and for achieving hemostasis after spleen and liver trauma, in "no sutures" corneal transplantation, pterygium excision with amniotic membrane or conjunctival autograft, and in eye trauma for corneal or conjunctival defects, as well as for skin graft donor site wounds to reduce postoperative pain.
Possible adverse effects include bleeding disorder and allergic reactions such as flushing, stinging, generalised urticaria, angioedema, bronchospasm, and anaphylaxis. Other adverse effects in studies occurred in roughly equal proportions in treatment and placebo groups.
Mechanism of action
Thrombin is an enzyme that splits fibrinogen into fibrin monomers in 10 to 60 seconds, which aggregate to form a three-dimensional gel-like structure. Thrombin also activates factor XIII from the human body to factor XIIIa, which then cross-links the fibrin monomers to form a stable clot. Both these processes need calcium to work. As the wound heals, the clot is slowly degraded by the enzyme plasmin.
Fibrin glue comes in two vials, respectively containing
- fibrinogen: lyophilised pooled human concentrate and
- thrombin: This used to be of bovine origin; modern formulations contain human thrombin.
Factors affecting structure
Factors that influence dimensional structure of fibrin gel giving rise to fine or coarse gel:
- Changing concentration of fibrinogen
- Changing concentration of thrombine – increased concentration increases ultimate tensile strength and Young modulus of gel
- Changing concentration of calcium
- TachoSil, a fibrin sealant in sponge form
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