Comparison of fibrin sealants in peripheral vascular surgery: A systematic review and network meta-analysis

Danker, Walter; DeAnglis, Ashley P.; Ferko, Nicole; Garcia, David; Hogan, Andrew J.

doi:10.1016/j.amsu.2020.12.003

Cited by 8 publications

(7 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although they observed few cases of superficial wound infections, the incidence did not differ between the fibrin glue and suture repair groups. Interestingly, meta-analyses on other surgical interventions (e.g., vascular surgery, hernia repair, and urethroplasty) concluded that the use of fibrin glue did not affect or even reduced wound-related complications [81][82][83][84] . These findings indicate that topical application of fibrin glue is relatively safe.…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis on the use of fibrin glue in peripheral nerve repair: Can we just glue it?

Koopman

Duraku

Jong

et al. 2022

Journal of Plastic, Reconstructive & Aesthetic Surgery

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis on the use of fibrin glue in peripheral nerve repair: Can we just glue it?

Koopman

Duraku

Jong

et al. 2022

Journal of Plastic, Reconstructive & Aesthetic Surgery

View full text Add to dashboard Cite

show abstract

“…Fibrin sealants are among the most prevalent technologies in the surgical toolbox, and, after more than a century of research, it is becoming increasingly clear that there is no universal sealant composition that matches all criteria relating to hemostatic or sealing efficacy, adequate adhesion, biosafety, cost effectiveness and ease of application. This is also reflected by recent meta‐analyses showing that positive effects of fibrin sealants on patient outcomes vary considerably depending on the fibrin sealant system used and the surgical setting 22,58–60 . Previous studies have focused on the clinical evaluation of fibrin sealants versus other natural or synthetic sealant systems, while comparative data, both clinical and non‐clinical, on individual products within the fibrin sealant class are still scarce.…”

Section: Discussionmentioning

confidence: 99%

A comparative high‐resolution physicochemical analysis of commercially available fibrin sealants: Impact of sealant osmolality on biological performance

Reichsöllner

Heher

Hartmann

et al. 2022

J Biomedical Materials Res

View full text Add to dashboard Cite

Fibrin sealants are well‐established components of the surgical toolbox, especially in procedures that harbor a high risk of perioperative bleeding. Their widespread use as hemostats, sealants or tissue‐adhesives in various surgical settings has shown that the choice of the appropriate sealant system affects the clinical outcome. While many studies have compared the hemostatic efficiency of fibrin sealants to that of other natural or synthetic sealants, there is still limited data on how subtle differences in fibrin sealant formulations relate to their biological performance. Here, we performed an in‐depth physicochemical and biological characterization of the two most commonly used fibrin sealants in the US and Europe: TISSEEL™ (“FS”) and VISTASEAL™/VERASEAL™ (“FS+Osm”). Our chemical analyses demonstrated differences between the two sealants, with lower fibrinogen concentrations and supraphysiological osmolality in the FS+Osm formulation. Rheological testing revealed FS clots have greater clot stiffness, which strongly correlated with network density. Ultrastructural analysis by scanning electron microscopy revealed differences between FS and FS+Osm fibrin networks, the latter characterized by a largely amorphous hydrogel structure in contrast to the physiological fibrillar network of FS. Cytocompatibility experiments with human fibroblasts seeded on FS and FS+Osm fibrin networks, or cultured in presence of sealant extracts, revealed that FS+Osm induced apoptosis, which was not observed with FS. Although differential sealant osmolality and amounts of fibrinogen, as well as the presence of Factor XIII or additives such as antifibrinolytics, may explain the mechanical and structural differences observed between the two fibrin sealants, none of these substances are known to cause apoptosis at the respective concentrations in the sealant formulation. We thus conclude that hyper osmolality in the FS+Osm formulation is the primary trigger of apoptosis—a mechanism that should be evaluated in more detail, as it may affect the cellular wound healing response in situ.

show abstract

“…Surgical bleeding is a common complication in almost all forms of surgeries, and prompt bleeding control and appropriate hemostasis are vital for successful operation and to prevent complications, such as hematomas or excessive bleeding that can endanger the patient’s life 1 , 2 , 3 . Surgical bleeding can cause higher infection rates and ventilator use and prolong hospitalization and operative time 4 , 5 , 6 causing considerable clinical and financial burdens 4 , 7 , 8 .…”

Section: Introductionmentioning

confidence: 99%

“…It provides improved hemostasis and wound repair and enables sealing of wounded surfaces and tissues 1 , 10 , 11 , 12 , 13 . Such sealants possess several beneficial properties, namely quick activation, natural clotting process simulation, favorable safety profile, and reabsorbability 3 , 5 , 14 . Fibrin sealants have demonstrated better results than the conventional techniques for reducing intraoperative blood loss 5 , 13 , 15 , 16 , 17 .…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of sFilm-FS, a novel biodegradable fibrin sealant, in Göttingen minipigs

Ramot

Steiner²,

Lavie³

et al. 2021

J Toxicol Pathol

View full text Add to dashboard Cite

Bleeding during surgical procedures is a common complication. Therefore, hemostatic agents have been developed to control bleeding, and fibrin sealants have several benefits. sFilm-FS is a novel fibrin sealant that comprises a biodegradable copolymeric film embedded with human fibrinogen and thrombin. Herein, the safety and efficacy of sFilm-FS were compared using a liver and spleen puncture model of Göttingen minipigs with those of the standard hemostatic techniques (control animals) and EVARREST ® , a reference fibrin sealant. Hemostasis and reduced blood loss were more effectively achieved with sFilm-FS than with the standard techniques in the control animals and comparable to those achieved with EVARREST ® . No treatmentrelated adverse effects were observed in any of the groups. Histopathological evaluation indicated that sFilm-FS was slightly and moderately reactive at the liver puncture site and spleen, respectively, compared with the standard techniques in the control animals. These changes are expected degradation reactions of the copolymeric film and are not considered as adverse events. No treatment-related abnormalities were noted in the other evaluated organs. Additionally, no evidence of local or systemic thromboses was noted. These results support the use of sFilm-FS for hemostasis in humans.

show abstract

Comparison of fibrin sealants in peripheral vascular surgery: A systematic review and network meta-analysis

Cited by 8 publications

References 37 publications

A systematic review and meta-analysis on the use of fibrin glue in peripheral nerve repair: Can we just glue it?

A systematic review and meta-analysis on the use of fibrin glue in peripheral nerve repair: Can we just glue it?

A comparative high‐resolution physicochemical analysis of commercially available fibrin sealants: Impact of sealant osmolality on biological performance

Safety and efficacy of sFilm-FS, a novel biodegradable fibrin sealant, in Göttingen minipigs

Contact Info

Product

Resources

About