Could Fibrin Sealants (TISSEEL^TM) Be Effective in the Management of Burn Injuries? A Histopathological Study in Rats

Background: Burn injuries remain a major clinical problem worldwide, which require special management by experienced plastic surgeons. However, they cannot be available in every healthcare unit; consequently, there is a need for effective treatment options that could be utilized by a wide range of non-expert healthcare professionals. The aim of the present experimental study was to investigate the safety and efficacy of using a fibrin sealant (TISSEEL^TM) compared to the conventional treatment with sulfadiazine on partial-thickness burn in a rat animal model. Methods: A cohort of Sprague Dawley rats underwent partial-thickness contact thermal burn wounds and were divided into three study groups: control group (no treatment), silver sulfadiazine cream group and TISSEEL^TM group. Following animal sacrifice, a blinded histopathologic analysis was conducted regarding inflammatory response, healing and tissue regeneration. Results: In total, 30 animals were included with a median weight of 236 ± 10 g. Two animals from the control group died on the first postoperative day. Animals in the TISSEEL^TM group presented dominant collagen expression compared to animals in the control and silver sulfadiazine cream group (p = 0.000). Histopathologic analysis also demonstrated marked leukocyte infiltration (p = 0.009), increased neovascularization (p = 0.000) and higher fibroblast expression (p = 0.002) in the TISSEEL^TM group compared to the other two groups. Conclusions: TISSEEL^TM seems to be a safe alternative (or even principal) option for the initial therapeutic approach of partial-thickness burn injuries. Moreover, it seems to be superior to silver sulfadiazine in terms of tissue healing and regeneration. However, additional experimental as well as clinical research is necessary prior to implementation in clinical practice.