This
glue is used as a
supportive treatment in surgery (such as liver surgery) for the improvement of
hemostasis where standard surgical techniques are insufficient or impractical.[18][19]
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.[25]
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.[16][25][26]
Pharmacokinetics
In rabbit studies, only 1 to 2% of the applied thrombin dose reached the bloodstream. It reached highest
blood plasma concentrations after 6 to 8 hours.[25]
Chemistry
Composition
Fibrin glue comes in two vials, respectively containing:
A formulation with human thrombin was approved for medical use in the United States in March 2003, and in the European Union in October 2008.[18][27][30]
References
^
ab"VeraSeal". Therapeutic Goods Administration (TGA). 12 November 2021. Retrieved 28 December 2021.
^Shah NV, Meislin R (December 2013). "Current state and use of biological adhesives in orthopedic surgery". Orthopedics. 36 (12): 945–956.
doi:
10.3928/01477447-20131120-09.
PMID24579215.
^Shinohara K, Kobayashi E, Yoshida T, Toyama N, Kiyozaki H, Fujimura A, Miyata M (1998). "Effect of fibrin glue on small and large bowel anastomoses in the rat". European Surgical Research. 30 (1): 8–12.
doi:
10.1159/000008552.
PMID9493689.
S2CID46792418.
^Spotnitz WD, Mintz PD, Avery N, Bithell TC, Kaul S, Nolan SP (August 1987). "Fibrin glue from stored human plasma. An inexpensive and efficient method for local blood bank preparation". The American Surgeon. 53 (8): 460–462.
PMID2440358.
^Mücke T, Wolff KD (2009). "Performing microvascular anastomosis with fibrin glue--faster, easier, and more reliable?". Microsurgery. 29 (1): 80–81.
doi:
10.1002/micr.20556.
PMID18946885.
S2CID31854904.
^
abc"Evicel EPAR". European Medicines Agency. 17 September 2018. Retrieved 12 June 2020. This article incorporates text from this source, which is in the
public domain.
^Narendran N, Mohamed S, Shah S (July 2007). "No sutures corneal grafting--a novel use of overlay sutures and fibrin glue in Deep Anterior Lamellar Keratoplasty". Contact Lens & Anterior Eye. 30 (3): 207–209.
doi:
10.1016/j.clae.2007.02.007.
PMID17379570.
^Sinha S, Schreiner AJ, Biernaskie J, Nickerson D, Gabriel VA (November 2017). "Treating pain on skin graft donor sites: Review and clinical recommendations". The Journal of Trauma and Acute Care Surgery. 83 (5): 954–964.
doi:
10.1097/TA.0000000000001615.
PMID28598907.
S2CID44520644.