Effects of a Fibrin Sealant on Skin Graft Tissue Adhesion in a Rodent Model

Balceniuk, Mark D.; Wingate, Nicholas; Krein, Howard; Curry, Joseph M.; Cognetti, David M.; Heffelfiner, Ryan; Luginbuhl, Adam

doi:10.1177/0194599816634616

Cited by 5 publications

(5 citation statements)

References 13 publications

(43 reference statements)

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“…Adhesive glue provides additional mechanical stability. In a rat model, a thin layer of fibrin glue was associated with greater adherence strength determined by the amount of force required to sheer the graft from the wound on postoperative days 1 to 3 33 . Several studies show that use of glue is associated with lower rates of hematoma or seroma 34,35 .…”

Section: Resultsmentioning

confidence: 99%

“…In a rat model, a thin layer of fibrin glue was associated with greater adherence strength determined by the amount of force required to sheer the graft from the wound on postoperative days 1 to 3. 33 Several studies show that use of glue is associated with lower rates of hematoma or seroma. 34,35 From a patient perspective, glue is a useful aid for fixation in sensitive areas, reducing pain associated with staples or sutures.…”

Section: Retrospective Cohort Comparison (Iii)mentioning

confidence: 99%

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Safeguarding Skin Grafts

Patel

Asher²,

Bystrzonowski³

et al. 2021

Ann Plast Surg

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Background Effective skin graft fixation is vital in preventing sheering forces, seroma, and hematoma from compromising graft take. Yet, selecting the ideal technique for securing skin grafts remains a contentious subject, with significant variation in practice existing between surgeons. There is, therefore, benefit to be derived from assessing the literature for evidence-based recommendations to guide the decision-making process. Methods A search of Medline and Embase was performed using appropriate key terms, yielding 419 articles. Reference lists were analyzed. Inclusion and exclusion criteria were composed. Level I to III studies, as defined by the Centre for Evidence-Based Medicine, that compared skin graft fixation methods were analyzed. Rayyan QCRI was used for abstract and title screening. After full text screening, 41 studies were included for qualitative analysis. All included randomized control trials (RCTs) were assessed for risk of bias using the Cochrane Risk-of-Bias 2 (ROB2) tool. Results We identified 4 groups of fixation technique: “tie-over bolster” (TOB), “no TOB,” “adhesive glues,” and “negative pressure wound therapy” (NPWT). Twelve studies compared TOB with no TOB, with no difference in graft take demonstrated. Sixteen studies compared adhesive glues with traditional methods, with no difference in graft take demonstrated. Thirteen studies compared NPWT with traditional methods, with enhanced graft take demonstrated. Risk of bias was deemed low in 1 of 13 RCTs. Conclusions Based on the current evidence, only NPWT is associated with enhanced graft take. However, there is a scarcity of robust level I evidence comparing different fixation techniques, meaning that strong recommendations cannot be made. We propose examples of hypothesis-driven RCTs, in predetermined clinical settings, based on the theoretical benefits of the techniques that would add value to clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Retrospective Cohort Comparison (Iii)mentioning

confidence: 99%

Safeguarding Skin Grafts

Patel

Asher²,

Bystrzonowski³

et al. 2021

Ann Plast Surg

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“…Perez-Guisado et al recommended the use of fibrin glue to increase the possibility of skin graft survival [7]. Also, Balceniuk et al concluded that the fibrin glue used in skin grafting techniques helps in minimizing graft loss and lowers the rate of complications [8]. Butts et al reported significantly lower rates of skin graft loss while using fibrin glue [9,10].…”

Section: Discussionmentioning

confidence: 99%

Restoration of soft triangle of the nose using auricular composite graft and fibrin glue

Mohamed

Eldehn²

2020

Acta Oto-Laryngologica Case Reports

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The impact of fibrin glue on helical composite graft take and outcome after reconstruction of the soft triangle of the nose was demonstrated. A superior helical ear composite graft was harvested for the reconstruction of the soft triangle of the left nostril. Fibrin glue is used frequently with split-thickness skin grafts but not with composite grafts before. It was used intraoperatively as a sealant, haemostatic and fixating agent, promote wound healing and prevent skin graft contracture. The complete composite graft-take occurred along with good aesthetic outcome and integration. The symmetry of both nostrils was restored. No graft shrinkage or contracture was observed for more than 10 months follow up. In this case, fibrin glue helped the composite graft complete take and integration with the restored good aesthetic appearance and minimal graft contraction. The level of evidence was-Therapeutic, V.

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“…Risk of complications in STSG placement vary based on patient demographics, comorbidities, and recipient graft site. 21 However, recent reports exploiting FG’s adherent properties for skin graft fixation are increasing, especially in animal research 22–26 and clinically in burn patients. 27–29 These clinical studies, although small in quantity, have reported positive outcomes with fewer graft loss and a decrease in hospital stay.…”

Section: Discussionmentioning

confidence: 99%

To Glue or Not to Glue? Analysis of Fibrin Glue for Split-thickness Skin Graft Fixation

Mullens

Messa

Kozak

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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Background: Split-thickness skin grafting (STSG) is a commonly used tool in the plastic surgeon’s reconstructive armamentarium. Fibrin glue (FG) consists of a combination of clotting factors and thrombin whose key properties include adherence and hemostasis. This preliminary study aimed to assess clinical outcomes and cost of FG for STSG fixation in a general wound reconstruction. Methods: A retrospective review was conducted in all patients undergoing STSG placement by a single surgeon (JPF) from January 2016 to March 2018. Twenty patients were identified and matched by wound location and wound size. Patients were then divided into 2 groups based on the method of STSG fixation: FG (n = 10) or suture only (SO) (n = 10). Results: In patients with FG fixation, we observed trends of decreased adjusted operative times (34.9 versus 49.4 minutes, P = 0.612), a similar length of stay (2.8 versus 3.5 days, P = 0.306), and liberation from the use of negative pressure wound therapy (0 versus 10 wounds, P < 0.0001). There were no observed differences between the 2 groups in terms of graft-related complications at 180 days (1 complication FG versus 0 complications SO). Time to 100% graft take was also not different (20.2 versus 29.4 days, P = 0.405). Additionally, total direct cost ($16,542 FG versus $24,266 SO; P = 0.545) and total charges ($120,336 FG versus $183,750 SO; P = 0.496) were not statistically different between the FG and SO groups. Conclusions: In this preliminary comparative assessment, FG for STSG fixation has shown no difference in clinical outcomes to SO fixation, trends of decreased operative time, and afforded complete liberation from negative pressure wound therapy dressings.

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Effects of a Fibrin Sealant on Skin Graft Tissue Adhesion in a Rodent Model

Abstract: There is a significant difference in the adhesion strength of skin grafts to the wound bed in the early postoperative period of the 2 groups. In areas of high mobility, using the fibrin sealant can keep the graft immobile during the critical phases of early healing.

Cited by 5 publications

References 13 publications

Safeguarding Skin Grafts

Safeguarding Skin Grafts

Restoration of soft triangle of the nose using auricular composite graft and fibrin glue

To Glue or Not to Glue? Analysis of Fibrin Glue for Split-thickness Skin Graft Fixation

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