Fibrin glue

Fibrin glue or adhesive (also tissue glue ) is a physiological two-component adhesive biological origin. He finds in medical applications such as:

  • Bonding of wound edges instead of a classical surgical suture and closure of injured tissue;
  • Suture support problematic seams;
  • Hemostasis of otherwise uncontrollable bleeding;
  • Support and accelerate wound healing.

A principal advantage of the fibrin glue - over the conventional surgical suture - is the protection of particularly sensitive tissue and the formation of less conspicuous scars, since no stitches with needle and thread to be set. In fact, the fibrin adhesive adheres the tissue to the wound edges together continuously, to the body's own wound healing has corrected the damage.

Components

Operation

The components 1 and 2 are mixed, the thrombin cleaves fibrinogen into fibrin and activates the factor XIII to factor XIIIa. Factor XIIIa leads to a cross-linking of fibrin, which is a stable, tear-resistant but at the same time elastic fibrin results. This process corresponds to the last section of natural blood clotting. Therefore, the fibrin can also be dissolved by the body's own enzymes ( lysed ) are. A " stringy " after wound healing is therefore superfluous. Fibrin glue is particularly suitable therefore for use inside the body. Factor XIIIa is incorporated in the clot and in the fibrin clot by fibrinolysis, the delay in its natural function. In order to ensure also under difficult conditions a sufficient wound healing, 1 aprotinin is contained in the component. Aprotinin delayed fibrinolysis by binding to the enzyme plasmin. Because this is a reversible binding, the plasmin is not useless, but is hindered in its function only. Thus, the lysis action slowed.

Preparation of the individual components

Application possibilities and application examples

The administration (application ) of the components can be successively ( one after the other: first component 1, component 2), or simultaneously ( both components at the same time ) carried out by spraying with a particular double - syringe. Fibrin glue can also be used for endoscopic methods. The following list gives a brief overview of the many applications of fibrin glue.

  • The organs liver, spleen, lung, pancreas and kidney: Compound of the wound margins after injury or surgery, without causing further damage, such as would be the case in the conventional surgical suture. Bleeding be stopped quickly, which is a big advantage with these often heavily bleeding organs.
  • Skin: Improved and faster growth of transplants for the treatment of burns and also a better protection against infections. Fibrin glue ensures a gas-and water -tight wound closure and prevents the penetration of pathogens.
  • Ophthalmology: When operations on the eye lens (eg " cataract " ), the new lens glued into the eye, rather than sewn.
  • Cosmetic surgery: avoiding additional scars by seams and improved wound healing.
  • Treatment of bleeding gastric or intestinal injury via an endoscope through direct application of the fibrin glue.
  • Numerous application examples in the ear, nose and throat medicine, because here are the areas to be treated often difficult to access and / or very small and delicate.

References and notes

Since there are biological substances in the raw materials fibrinogen, thrombin, factor XIII and aprotinin, an infection with pathogens is completely excluded. The ingredients produced by plasma fractionation this particularly affects the risk of infection with HIV and hepatitis B, and other pathogens that can be transmitted through blood products. Fibrin glue is widely used in Germany today. The considerable cost of the components are doing as opposed to benefit from its application. So an extension of the applications to less difficult cases is currently for cost reasons often not possible. Nevertheless, the application of fibrin glue will be tested again and again new areas to improve the success of treatment of the conventional methods.

An interesting alternative / complement to fibrin is the best since 1964, in medicine cyanoacrylate. It can stop massive bleeding, seam- sealed wounds and is due to the purely chemical production presents no risk of infection

Tissue (biology) Blood plasma Blood plasma fractionation Fermentation
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