[Human fibrin glue in head and neck surgery]

Promoting tissue adhesion is of concern in almost all areas of surgery. Human fibrin, thrombin and clotting factor XIII have important roles in the healing of wounds and in scar formation. The gluing material we use is a prefabricated fibrinogen concentrate produced from pooled human blood plasma (Tisseel Kit, Immuno), obtained from plasmapheresis centers in Central Europe and the US. The gluing solution averages 110 mg/ml of coagulable material. On applying a thrombin solution (by dripping it onto the area), fibrinogen coagulated in 8-10 seconds (quick coagulation) or 30-50 seconds (slow coagulation). Fibrin glue is valuable in tissue synthesis and tissue adhesion, particularly where conventional suture methods would be difficult. We summarize results in 53 patients operated on between 1985-1993. The Tisseel tissue adhesive system was used for coating and sealing during tympanoplasty (18 patients), and for closure of perilymphatic fistulas (18), chylous fistulas (2), oral and pharyngeal fistulas (3), cerebrospinal fluid leaks (4), facial nerve injury (1), and in split-thickness skin graft and local skin flap application in hereditary hemorrhagic telangiectasia (7). Tissue glue is valuable in tissue repair and local hemostasis, facilitates the surgeon's work and may obviate more complicated surgical procedures.