Fibrin sealant in wound repair: a systematic survey of the literature

Fibrin sealants have recently been approved for clinical use in the US by t he FDA and have been available for clinical use in Europe for years. The in dication for use in the US is haemostasis. Nevertheless, both commercial an d non-commercial fibrin sealant preparations are also for wound healing and for prevention of abdominal adhesions in the US and Europe. To the non-cog noscenti of fibrin sealants, their use to promote wound repair and to preve nt abdominal adhesions appears contradictory since an agent that promotes c onnective tissue repair might be expected to promote abdominal adhesion rat her than prevent them. In this systematic survey of the animal and clinical data evidence is presented that supports both off-label uses. However ther e is much inconsistency in the data secondary to the use of various fibrin sealant preparations, different animal models and clinical situations and d ifferent application techniques. It is clear from this survey that standard preparation and application of fibrin sealant for a particular surgical se tting are needed to resolve the many apparent discrepancies in the literatu re. A corollary to this is the likelihood that different fibrin sealant pre parations may be preferred for different clinical situations.