Fibrin glues promise healing breakthrough
February 1, 1998 2 minutes read
Fibrin glues promise healing breakthrough
Major breakthroughs in the use of fibrin-based tissue adhesives for wound closure and healing will occur in the next five to 10 years, according to a University of Virginia physician."As soon as surgeons are allowed to use glues in effective ways, there is going to be a wide variety of new applications," says William D. Spotnitz, MD, FACS.
While tissue adhesives made from fibrin and thrombin (both naturally occurring substances) have been used for years in Europe, Canada, and Japan, these adhesives have not yet been approved by the U.S. Food and Drug Administration. The FDA is concerned that they might spread viral diseases such as hepatitis, because the compounds used to make them are collected from hundreds of donors.
But the development of antiviral technology that prevents the transmission of viral diseases from products derived from pooled plasma may accelerate the acceptance and regulatory approval of these adhesives. "There are very effective mechanisms for doing that, such as dry cleaning, filtering, or heating blood, some of which have been approved by the FDA to safeguard the nation’s blood supply," Spotnitz says.
Another reason for the great interest in fibrin tissue adhesives is their dual hemostatic and wound-healing actions, says Spotnitz. Fibrin provides an initial step in the formation of blood clots and scars. "Because we are using the body’s own ability to clot and using the clot as a glue, we achieve several capabilities," he explains. "First, the fibrin tissue adhesives promote clotting wherever they are applied. They can be used to stop bleeding from a variety of sources, such as from suture lines at the time of cardiovascular surgery, or from adhesions, grafts, trauma to the spleen or liver, or bleeding at the time of vascular anastomoses."
Spotnitz adds that fibrin tissue adhesives also are excellent healing agents and are biodegradable. "Fibrin is broken down in the body just as any other blood clot is metabolized and destroyed. There is very little likelihood, therefore, that they will cause carcinogenesis or other long-term dangers," he says.
Researchers at the University of Virginia’s Tissue Adhesive Center recently investigated the effectiveness of Vitex tissue adhesive after lumpectomy and axillary lymph node dissection in 40 women, finding that the compound significantly reduced postoperative drainage.
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