Oliver D W, Hamilton S A, Figle A A, Wood S H, Lamberty B G
Department of Plastic and Reconstructive Surgery, Stoke Mandeville Hospital, Aylesbury, England.
Plast Reconstr Surg. 2001 Dec;108(7):2101-5, discussion 2106-7. doi: 10.1097/00006534-200112000-00044.
Fibrin sealant imitates the final phase of the blood coagulation process. Fibrinogen is converted into fibrin on a tissue surface by the action of thrombin, which is then cross-linked by factor XIIIa, creating a mechanically stable fibrin network. This fibrin network is thought to reduce the amount of postoperative bleeding by sealing capillary vessels and allowing raw operative surfaces to adhere. The authors conducted a prospective, double-blind, randomized, controlled trial on the use of fibrin sealant in 20 consecutive patients undergoing bilateral face lifts by the same surgeon. Each patient was randomized for the use of fibrin sealant on either the right or the left side with the contralateral side acting as the control. Total drainage was recorded on each side for 24 hours before drains were removed. The age range of the patients in the trial (all of whom were women) was 44 to 70 years (mean, 55). The side treated with fibrin glue had a median drainage of 10 ml and the control side 30 ml. The Wilcoxon signed rank test shows a significant difference in drainage between sides (p = 0.002). The reduction in postoperative drainage could also reduce pain and bruising, increasing patient satisfaction with this procedure. The need for drains may also be obviated.
纤维蛋白密封剂模仿血液凝固过程的最后阶段。在组织表面，纤维蛋白原在凝血酶的作用下转化为纤维蛋白，然后由因子XIIIa进行交联，形成机械稳定的纤维蛋白网络。该纤维蛋白网络被认为可通过封闭毛细血管和使手术创面粘连来减少术后出血量。作者对同一外科医生连续进行双侧面部提升手术的20例患者使用纤维蛋白密封剂进行了一项前瞻性、双盲、随机对照试验。每位患者被随机分配在右侧或左侧使用纤维蛋白密封剂，对侧作为对照。在拔除引流管前，记录每侧24小时的总引流量。试验中患者（均为女性）的年龄范围为44至70岁（平均55岁）。使用纤维蛋白胶治疗的一侧中位引流量为10 ml，对照侧为30 ml。Wilcoxon符号秩检验显示两侧引流量存在显著差异（p = 0.002）。术后引流量的减少还可减轻疼痛和瘀伤，提高患者对该手术的满意度。引流管的需求也可能得以避免。
