The Role of Sutures and Fibrin Sealant in Wound Healing

Spotnitz, William D.; Falstrom, Jeanne K.; Rodeheaver, George T.

doi:10.1016/s0039-6109(05)70573-9

Cited by 116 publications

(69 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…18 This activity was evident on the histologic evaluation of specimens taken from FS-fixed meshes, where there was a significant fibroblastic growth compared with the other two groups.…”

Section: Discussionmentioning

confidence: 92%

“…FS has been studied extensively and has proven to be effective in numerous clinical applications. 17,18 FS was approved for clinical use in the United States in 1998 and is available commercially (Tisseel, Baxter Healthcare Corp, Hyland Immuno Division, Deerfield, IL). It has been used as a powerful hemostatic agent in cardiothoracic and trauma surgery.…”

Section: Resultsmentioning

confidence: 99%

“…26 Any additional tissue incorporation would be dependent on neocollagen deposition and remodeling. 18 Moreover, fixation is critical during this early period to avoid displacement. After this phase, the secondary healing process is responsible for graft incorporation.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Use of Fibrin Sealant for Prosthetic Mesh Fixation in Laparoscopic Extraperitoneal Inguinal Hernia Repair

et al. 2001

View full text Add to dashboard Cite

ObjectiveTo evaluate the efficacy of mesh fixation with fibrin sealant (FS) in laparoscopic preperitoneal inguinal hernia repair and to compare it with stapled fixation. Summary Background DataLaparoscopic hernia repair involves the fixation of the prosthetic mesh in the preperitoneal space with staples to avoid displacement leading to recurrence. The use of staples is associated with a small but significant number of complications, mainly nerve injury and hematomas. FS (Tisseel) is a biodegradable adhesive obtained by a combination of human-derived fibrinogen and thrombin, duplicating the last step of the coagulation cascade. It can be used as an alternative method of fixation. MethodsA prosthetic mesh was placed laparoscopically into the preperitoneal space in both groins in 25 female pigs and fixed with either FS or staples or left without fixation. The method of fixation was chosen by randomization. The pigs were killed after 12 days to assess early graft incorporation. The following outcome measures were evaluated: macroscopic findings, including graft alignment and motion, tensile strength between the grafts and surrounding tissues, and histologic findings (fibrous reaction and inflammatory response). ResultsThe procedures were completed laparoscopically in 49 sites. Eighteen grafts were fixed with FS and 16 with staples; 15 were not fixed. There was no significant difference in graft motion between the FS and stapled groups, but the nonfixed mesh had significantly more graft motion than in either of the fixed groups. There was no significant difference in median tensile strength between the FS and stapled groups. The tensile strength in the nonfixed group was significantly lower than the other two groups. FS triggered a significantly stronger fibrous reaction and inflammatory response than in the stapled and control groups. No infection related to method of fixation was observed in any group. ConclusionAn adequate mesh fixation in the extraperitoneal inguinal area can be accomplished using FS. This method is mechanically equivalent to the fixation achieved by staples and superior to nonfixed grafts. Biologic soft fixation with FS will prevent early graft migration and will avoid the complications associated with staple use.Laparoscopic hernia repair is an effective technique, offering more rapid recovery and less pain than with the traditional open approach; recurrence rates are equivalent to those of the traditional open approach.

show abstract

“…18 This activity was evident on the histologic evaluation of specimens taken from FS-fixed meshes, where there was a significant fibroblastic growth compared with the other two groups.…”

Section: Discussionmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Use of Fibrin Sealant for Prosthetic Mesh Fixation in Laparoscopic Extraperitoneal Inguinal Hernia Repair

et al. 2001

View full text Add to dashboard Cite

show abstract

“…The fibrin polymer resulting from fibrin sealant application facilitates wound healing by increasing tissue plane adherence, thus eliminating dead space, accelerating revascularization, reducing hemorrhage, preventing seroma, and minimizing inflammation (40).…”

Section: Tissue Planesmentioning

confidence: 99%

Current applications of fibrin sealant in urologic surgery

Evans

Morey

2006

Int. braz j urol.

View full text Add to dashboard Cite

Biosurgical preparations designed to promote surgical hemostasis and tissue adhesion are being increasingly employed across all surgical disciplines. Fibrin sealant is the most widely studied and utilized biosurgical adjunct in urology. Complex reconstructive, oncologic, and laparoscopic genitourinary procedures are those most appropriate for sealant use. This article details the diverse urologic applications of fibrin sealant in the management of genitourinary injuries, surgery, and complications.

show abstract

“…This may complicate wound treatment and lead to impaired wound healing and hypertrophic scarring [12]. Furthermore, fibrin glue can be hazardous with respect to transmittable diseases like HIV and hepatitis [13].…”

Section: Introductionmentioning

confidence: 99%

Laser‐mediated fixation of collagen‐based scaffolds to dermal wounds

et al. 2010

View full text Add to dashboard Cite

Background and Objective: Collagen scaffolds are popular for the reconstitution of dermal equivalents. Usually, these scaffolds are fixed with sutures or staples and in many cases these devices have to be removed in a second procedure. Laser-mediated tissue welding in a wet environment is a potential alternative for collagen scaffold fixation and may be advantageous to suture, staple, and tissue glue fixation. Materials and Methods: Welding was performed with a continuous-wave diode laser system emitting radiation at a wavelength of 968 nm. Tensile strength after fixation to porcine skin and laser parameters were determined in vitro. In vivo, 24 excisional deep partial thickness wounds were created on flanks of two Goettingen mini pigs and covered with collagen scaffolds. These were randomized and fixated with either (1) staples, (2) fibrin glue, or (3) laser-mediated welding. Tissue biopsies for histological analysis were periodically performed and analyzed for wound healing progression, epidermal thickness, and extracellular matrix formation. Results: Biomechanical stability after laser welding was time dependent. A dwell time of up to 10 seconds led to a strong bonding with a tensile strength of more than 30 g. In vivo, the wound healing process was macroscopically comparable in all groups and showed no significant differences. Microscopic analysis determined a more progressed and quicker wound closure in both the laser and staples group compared to the fibrin glue fixated scaffold. Laser-mediated fixation led to a significantly reduced epidermal thickness when compared with stapling or fibrin glue (P < 0.05). Conclusions: Laser tissue welding is a feasible approach for temporary fixation of collagen scaffolds to the wound bed. It improves wound healing properties and may lead to faster wound healing and cosmetically better scarring. Laser tissue welding is thus a very interesting and promising alternative to currently established fixation methods in a single step, no touch procedure

show abstract

The Role of Sutures and Fibrin Sealant in Wound Healing

Cited by 116 publications

References 44 publications

Use of Fibrin Sealant for Prosthetic Mesh Fixation in Laparoscopic Extraperitoneal Inguinal Hernia Repair

Use of Fibrin Sealant for Prosthetic Mesh Fixation in Laparoscopic Extraperitoneal Inguinal Hernia Repair

Current applications of fibrin sealant in urologic surgery

Laser‐mediated fixation of collagen‐based scaffolds to dermal wounds

Contact Info

Product

Resources

About