Canonico Silvestro
School of Medicine, Department of Gerontology and Geriatric, Section of Surgery, 2nd University of Naples.
Acta Biomed. 2003;74 Suppl 2:21-5.
Human Fibrin Glue (HFG) is made of two components contained in separate vials: a freeze dried concentrate of clotting proteins, mainly fibrinogen, Factor XIII and fibronectin (the sealant) and freeze dried thrombin (the catalyst). The first component is reconstituted with an aprotinin solution that inhibits tissue fibrinolysis. The second component (thrombin), available in 500 I.U. concentration, is dissolved with calcium chloride. It is so a set of substances involved in the hemostatic process and in the wound healing, conferring to the product the following important properties: hemostatic and sealing action, through the strengthening of the last step of the physiological coagulation; biostimulation, which favors the formation of new tissue matrix. The indications for the use of human fibrin sealant are numerous and present in all the surgical branches. A randomized controlled trial of 50 patients undergoing hernia repair according to Lichtenstein's technique under local anesthesia was performed. Patients had concurrent coagulopathies as a consequence of liver disease or long-term treatment with anticoagulants for ischemic heart disease or cardiac rhythm disturbances. Coagulopathies were defined according to the following criteria: prothrombin time < 10.5 seconds, activated partial thromboplastin time < 21 seconds, and fibrinogen < 230 mg/dL. Patients were randomized in a 1:1 ratio with (group A) or without (control group B) use of human fibrin glue: Postoperative hemorrhagic complications were significantly reduced in group A (4%) compared with group B (24%). This study showed that human fibrin glue is effective in preventing local hemorrhagic complications after inguinal hernia repair in patients with concurrent coagulation disorders.
人纤维蛋白胶（HFG）由分别装在不同小瓶中的两种成分组成：一种是凝血蛋白的冻干浓缩物，主要是纤维蛋白原、凝血因子 XIII 和纤连蛋白（密封剂），另一种是冻干凝血酶（催化剂）。第一种成分用抑制组织纤维蛋白溶解的抑肽酶溶液复溶。第二种成分（凝血酶）浓度为 500 国际单位，用氯化钙溶解。因此，这是一组参与止血过程和伤口愈合的物质，赋予该产品以下重要特性：通过加强生理性凝血的最后一步实现止血和密封作用；生物刺激作用，有利于新组织基质的形成。人纤维蛋白密封剂的适用指征众多，存在于所有外科分支。对 50 例接受局部麻醉下 Lichtenstein 技术疝修补术的患者进行了一项随机对照试验。患者因肝病或因缺血性心脏病或心律失常长期接受抗凝治疗而并发凝血病。凝血病根据以下标准定义：凝血酶原时间<10.5 秒、活化部分凝血活酶时间<21 秒、纤维蛋白原<230mg/dL。患者按 1:1 比例随机分为使用（A 组）或不使用（对照组 B）人纤维蛋白胶：A 组术后出血并发症（4%）明显低于 B 组（24%）。这项研究表明，人纤维蛋白胶对预防并发凝血障碍患者腹股沟疝修补术后的局部出血并发症有效。
