Fibrin adhesive: its use in selected skin grafting. Practical note

The use of a fibrin adhesive to ensure the fixation of skin grafts in difficult situations was evaluated in 27 patients. Fibrin adhesive offers a fast and safe alternative to conventional methods, especially when dealing with concavities or other surfaces where it is impossible to obtain adequate fixation and prevent graft slippage. This type of adhesive has been used before, but too rapid fibrinolysis and a low concentration of fibrinogen made the method of little practical use. The method has been considerably improved by the addition of aprotinin, which is a proteolytic inhibitor and the achievement of a sufficient concentration of fibrinogen by various means. The specific advantages are: easy handling reduction of operating time, the absence of haematoma and good fixation. The price is somewhat prohibitive, but can be justified in terms of the improved results and the time saved when dealing with severely burned patients. In contrast to the synthetic glues, fibrin-adhesive does not prevent graft take through mechanical obstruction.