Fibrin glue for wound repair: facts and fancy

In wound repair, fibrin has a multiplicity of activities, some of which are intrinsic to the protein itself and some attributable to other blood constituents associated with the fibrin clot. Fibrin sealants, which have been approved for hemostasis in the US and Europe, are occasionally used wounds to promote healing. However, inconsistency exists in the literature regarding the benefit of these preparations in the healing process. More crude fibrinogen preparations, such as cryoprecipitates made from the patient's own blood on location, appear from the literature to have better utility in wounds than more purified fibrinogen preparations available through commercial sources. These divergent outcomes are likely attributable to additional blood-derived products being associated with cryoprecipitates compared to the relatively purified commercial fibrinogen preparations. Clearly standard preparations and methods of application of fibrin sealant need to be defined for each particular surgical setting to resolve the many ostensible discrepancies in the current literature. A corollary is that different fibrin sealant preparations are likely to be preferable for different clinical situations.