The Surgical Therapeutic Advancement Center, Department of Surgery, University of Virginia Health System, Charlottesville, VA, USA.
Clin Cosmet Investig Dermatol. 2012;5:43-51. doi: 10.2147/CCID.S25747. Epub 2012 May 24.
The purpose of this review is to clarify the present use of fibrin sealant in rhyditectomy procedures and help maximize the appropriate and safe application of this material. A set of terms and definitions for hemostats, sealants, and adhesives based on group, category, and class will be employed to highlight the specific capabilities of fibrin sealant. Fibrin sealant has now emerged as an example of maximizing the usefulness of a surgical agent and is the only product with Food and Drug Administration approval in all three groupings: hemostats; sealants; and adhesives. A variety of manufacturers' fibrin sealant products are available including multiple liquids and one patch. A single liquid product is now specifically indicated for skin flap adherence during rhytidectomy. The unique characteristic of this particular two component fibrin sealant adhesive agent is its slower polymerization rate as a result of a low thrombin concentration which when combined with fibrinogen permits adequate time for manipulation of flaps and tissues prior to final fixation. In addition to its flap adherence and potential space elimination capability, fibrin sealant is also an excellent blood clotting agent and can seal tissues to prevent lymphatic leak or serous fluid accumulation. Thus, it is almost ideally suited to reduce the occurrence of fluid accumulation, hematomas, ecchymoses, and swelling, as well as to possibly eliminate the need for drains following rhytidectomy. A literature review of fibrin sealant in rhytidectomy is included to help define the current state of its clinical use. The author's recommendations for the best use of this material during facial procedures are also provided.
这篇综述的目的是阐明纤维蛋白胶在除皱术中的当前应用，并帮助最大限度地合理安全地应用这种材料。将采用一套基于组、类别和级别的止血剂、密封剂和粘合剂的术语和定义，以突出纤维蛋白胶的特定功能。纤维蛋白胶现在已经成为最大限度提高手术制剂有用性的范例，是唯一一种在所有三个组：止血剂、密封剂和粘合剂中均获得美国食品和药物管理局批准的产品。有各种制造商的纤维蛋白胶产品，包括多种液体和一种贴片。目前有一种单一的液体产品专门用于除皱术中的皮瓣粘连。这种特殊的双组分纤维蛋白胶粘合剂的独特特点是其聚合速度较慢，因为其凝血酶浓度较低，与纤维蛋白原结合后，在最终固定之前，有足够的时间对皮瓣和组织进行操作。除了具有皮瓣粘连和潜在空间消除的能力外，纤维蛋白胶也是一种出色的凝血剂，可以密封组织，防止淋巴液泄漏或浆液性液体积聚。因此，它几乎非常适合减少液体积聚、血肿、瘀伤和肿胀的发生，并可能消除除皱术后引流的需要。本文还包括了对纤维蛋白胶在除皱术中的文献综述，以帮助确定其临床应用的现状。作者还就面部手术中使用这种材料的最佳方法提出了建议。
