Effect of Aerosolized Fibrin Sealant on Hemostasis and Wound Healing after Endoscopic Sinus Surgery: A Prospective Randomized Study

Abstract

Compared with polyvinyl acetal sponge, aerosolized FS shows beneficial effects on hemostasis and wound healing after FESS. The application of FS resulted in a high degree of patient satisfaction without additional morbidity.

Fibrin tissue adhesive versus nasal packing in endoscopic nasal surgery: a systematic review and meta-analysis

“…The studies by Vaiman et al and Gleich et al presented data as binary outcomes (24,26) ; the studies by Jung et al and Yu et al used an ordinal scale (0 = absent to 3 = severe) to grade the severity of outcomes measured by clinicians, and a VAS (0 = no symptoms to 10 = unbearable) to grade the severity of outcomes measured by participants (12,25) . Since bleeding was assessed by both clinicians and participants in some studies, the method used is indicated in the table (12,25) .…”

“…More recently, biodegradable haemostatics have been suggested as a new material for managing the postoperative symptoms of endoscopic nasal surgery. Fibrin tissue adhesive (FTA) is a biodegradable solution containing concentrated fibrinogen, Factor XIII, thrombin and calcium; supplied in gel form it adheres strongly to tissue at the surgical site achieving instant haemostasis (12,13) . The topical application of FTA also negates the need for any postoperative removal, limiting the pain felt by patients (13) .…”

“…Unfortunately, upon initial analysis it became apparent that one study did not include a denominator in the results (22) , and a second study was noted to have a significant overlap in participants after consultation with the author (23) . These studies were subsequently removed, and the remaining four studies underwent analysis (12,(24)(25)(26) .…”

Current and Alternative Therapies for Nasal Mucosa Injury: A Review

“…The idea of delivering coagulation cascade component into the nasal cavity centers around resolving the hemostasis phase to allow wound healing to progress [29]. A prospective study comparing the administration of aerosolized fibrin and non-absorbable nasal packing has revealed that crusting, adhesion, bleeding, granulation tissue formation, infection, and frontal sinus ostium stenosis after endoscopic surgery, as well as overall comfort, improve after using fibrin spray [30].…”

Chitosan promotes aquaporin formation and inhibits mucociliary differentiation of nasal epithelial cells through increased TGF-β1 production

“…Preventing adhesion formation and restoring mucociliary mucosa are major determinants of the success of ESS. Therefore, several biomaterials have been developed to achieve haemostasis and reduce postoperative adhesion formation (Chandra et al, ; Yu et al, ).…”