Use of Fibrin Sealants in Cardiovascular Surgery: A Systematic Review

Rousou, John A.

doi:10.1111/jocs.12099

Cited by 69 publications

(47 citation statements)

References 41 publications

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“…It will be interesting to test this idea using molecular-dynamics simulations, building on recent progress in modeling the structure and interactions of fibrinogen (40,41). In addition to providing insight into the molecular basis of the structural adaptation of blood clots under mechanical load, addressing this question could potentially contribute to the development of a molecular tool for tuning the stickiness of fibrin glues and sealants that are widely used in surgeries and regenerative medicine (42,43). The second question raised by our findings is whether other fibrous biopolymer networks can also benefit from this self-adhesion mechanism to extend their reversible strain-stiffening response.…”

Section: Discussionmentioning

confidence: 99%

Fibrin Networks Support Recurring Mechanical Loads by Adapting their Structure across Multiple Scales

Kurniawan

Vos

Biebricher

et al. 2016

Biophysical Journal

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Tissues and cells sustain recurring mechanical loads that span a wide range of loading amplitudes and timescales as a consequence of exposure to blood flow, muscle activity, and external impact. Both tissues and cells derive their mechanical strength from fibrous protein scaffolds, which typically have a complex hierarchical structure. In this study, we focus on a prototypical hierarchical biomaterial, fibrin, which is one of the most resilient naturally occurring biopolymers and forms the structural scaffold of blood clots. We show how fibrous networks composed of fibrin utilize irreversible changes in their hierarchical structure at different scales to maintain reversible stress stiffening up to large strains. To trace the origin of this paradoxical resilience, we systematically tuned the microstructural parameters of fibrin and used a combination of optical tweezers and fluorescence microscopy to measure the interactions of single fibrin fibers for the first time, to our knowledge. We demonstrate that fibrin networks adapt to moderate strains by remodeling at the network scale through the spontaneous formation of new bonds between fibers, whereas they adapt to high strains by plastic remodeling of the fibers themselves. This multiscale adaptation mechanism endows fibrin gels with the remarkable ability to sustain recurring loads due to shear flows and wound stretching. Our findings therefore reveal a microscopic mechanism by which tissues and cells can balance elastic nonlinearity and plasticity, and thus can provide microstructural insights into cell-driven remodeling of tissues.

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Section: Discussionmentioning

confidence: 99%

Fibrin Networks Support Recurring Mechanical Loads by Adapting their Structure across Multiple Scales

Kurniawan

Vos

Biebricher

et al. 2016

Biophysical Journal

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“…This being an autologous product, the risk for viral infection and autoimmune response is averted. Its usefulness has been demonstrated in several specialties (urology, thoracic and cardiac surgery, and plastic surgery) (7)(8)(9)(10)(11)(12)(13).…”

Section: Discussionmentioning

confidence: 99%

Using autologous platelet-rich plasma for the treatment of complex fistulas

Moreno-Serrano¹,

García-Díaz²,

Ferrer-Márquez³

et al. 2016

Rev Esp Enferm Dig

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Objective:This study aims to demonstrate the effectiveness and safety of autologous fibrin gel rich in platelet growth factors for the treatment of complex perianal fistulas.Material and methods: Prospective epidemiological study. Patients with complex perianal fistula or perianal fistula mere alteration of continence are included. identification of both holes and the journey, curettage of it and instillation of Vivostat PRF ® in the way it is done to observe excess material by OFE. The variables analyzed were: age, sex, use of prior Seton clinic prevalent type of fistula, postoperative complications, fistula closure and impaired quality of life using the SF-36 test (v2).Results: From January 2011 to May 2013 have involved 23 patients, 12 men and 11 women, with an average age of 49 years and a minimum follow-up of 12 months. Two dropped out. 17 patients had low transsphincteric fistulas, 2 and 2 high transsphincteric intersphincteric with impaired continence. The most common symptom is the discharge. Twelve patients had a loose seton (62%), of which nine cured. Of all the patients we have operated the success rate is 62%. No patient developed incontinence after treatment. Only two reported a worse quality of life after surgery.Conclusion: This study demonstrates that there is a clear benefit to the use of Vivostat PRF ® as a treatment for complex perianal fistulas. It is a highly reproducible technique with acceptable results and does not produce impairment of continence.

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“…This review did not raise any concerns regarding the sealants' safety or tolerability, while emphasizing that they provide effective hemostasis control in cardiac and vascular surgery. 23 The role of bleeding as an important predicting factor in morbidity was analyzed in the report on the use of a sealant in composite aortic root replacement in 56 patients. 24 The suture line in these operations was sealed with fibrin glue to prevent possible blood leakage.…”

Section: Recent Reports On Using Of Fibrin-based Sealants In Cardiac mentioning

confidence: 99%

Fibrin sealants in cardiac surgery: The last five years of their development and application

Novotný

Hlubocký²,

Mitáš³

et al. 2018

Adv Clin Exp Med

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This review article describes the use of fibrin glue or fibrin sealants and their development over the past 5 years, with a focus on cardiac surgery. The roles of various types of sealants that are available in hemostasis control are reviewed briefly, together with the various potential risks and side effects of their use. The results of experimental work reported during the last 5 years, clinical data from the same period and the safety aspects of fibrin-based glues and sealants are summarized, showing many advantages of their clinical application over the use of synthetic glues or sealants that may be stronger in some cases, but less safe. It can be concluded that the widespread use of fibrin sealants is fully justified, as it benefits the patient as well as the surgeon through the improved control of hemostasis without increasing any adverse effects or complications during surgical procedures.

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Use of Fibrin Sealants in Cardiovascular Surgery: A Systematic Review

Cited by 69 publications

References 41 publications

Fibrin Networks Support Recurring Mechanical Loads by Adapting their Structure across Multiple Scales

Fibrin Networks Support Recurring Mechanical Loads by Adapting their Structure across Multiple Scales

Using autologous platelet-rich plasma for the treatment of complex fistulas

Fibrin sealants in cardiac surgery: The last five years of their development and application

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