Safety and efficacy of currently available fibrin tissue adhesives

Purpose: The purpose of this study is to review preparation methods, bondin g power, preparation time, and costs associated with currently available au tologous and homologous fibrin tissue adhesive preparations. Methods: Two autologous fibrin tissue adhesive preparations (AFTA-A and AFT A-E), a single-donor homologous preparation, and 2 multiple-donor pooled ho mologous fibrin tissue adhesives, Vi-Guard and Tisseel, were evaluated and compared in relation to bonding power, preparation time, cost, bicompatabil ity, and biodegradability. Results: Vi-Guard and Tisseel showed significantly greater bonding strength s than their single-donor counterparts. AFTA-C offers the quickest preparat ion time. All preparations were found to be similar in biocompatability and biodegradability in soft tissue tests. Histology showed no infection or ti ssue reaction from adhesive exposure in any of the preparations. Conclusion: The optimal choice of a fibrin tissue adhesive is determined by the particular clinical indication. Currently available fibrin tissue adhe sives vary appreciably in their bonding strength, cost, level of exposure r isk, and preparation methods and times. Autologous preparations, which offe r optimal safety, lack the strength and availability characteristics found with the multiple-donor preparations.