University of Virginia Health System

U.Va. First Hospital In Country To Use Surgical Fibrin Sealant

This is a major breakthrough in the area of tissue adhesives, said Dr. William Spotnitz, professor of surgery and director of the Tissue Adhesive Center at U.Va. This commercial form is more readily available, forms a stronger adhesive and appears to involve less risk than the adhesive made in the traditional method.

The new adhesive glue, known as fibrin sealant, is made by combining two human blood products, thrombin and fibrinogen, which form a gelatin-like substance that activates the body's natural clotting process. Both the thrombin and fibrinogen are put through extensive anti-viral treatments to minimize the risk of transmitting diseases.

Previously, surgeons at U.Va. worked with the U.Va. Blood Bank to manufacture their own fibrin sealant by combining a form of cow thrombin with fibrinogen extracted from donated blood. Using the bovine thrombin puts patients at a slight risk of allergic reaction or of developing a disease related to coagulation, Spotnitz said. The commercially produced form uses human thrombin, which lessens these risks.

The new fibrin sealant, distributed by Haemacure Corp. under the name Hemaseel APR, received FDA approval in May for use in cardiovascular surgery, repair of the spleen and closure of colostomy.

Spotnitz used the new fibrin sealant on June 17 in an aortic valve replacement operation. In cardiac and thoracic surgery, we use a lot of heparin, which can cause bleeding, he said. We used the fibrin sealant to reinforce the aortic suture-line closure. We had excellent results. It didn't bleed at all.

The U.Va. Tissue Adhesive Center is currently conducting clinical trials to test various forms of fibrin sealants for other types of surgery.

June 22, 1998