Poma Salvatore, Modica Domenico-Michele, Mattina Gianfranco, Gallina Salvatore, Azzolina Alfio-Alfonso, Mario-Galfano Giuseppe
Otorhinolaryngology Unit, Villa Sofia-Cervello Hospital, Palermo, Italy.
Otorhinolaryngology Unit, Department of Bi. N. D., University of Palermo, Palermo, Italy.
Iran J Otorhinolaryngol. 2021 Jan;33(114):3-8. doi: 10.22038/ijorl.2020.42520.2385.
There are many fibrin-derived sealants used as topical haemostatic agents in many surgical procedures. Fibrin sealants are usually non-autologous derivatives or animal derivatives, with the exception of Vivostat®, an autologous fibrin sealant derived from patients own blood.
We present our experience on the use of Vivostat® in skull base closures in 20 patients operated at the Otorhinolaryngology Unit of the Hospital Ospedali Riuniti Villa Sofia - Cervello of Palermo. All postoperative patients were placed in an anti-trendeleburg position for 48 hours. After removal of the nasal swabs we did not find any rhinorrhea and we checked the tightness of the skull base defect with computed tomography.
On a total of the 20 patients (10 post-traumatic and 10 with iatrogenic leaks), 9 out of 10 post-traumatic cases had a leak in the border area between the anterior and posterior portion of the ethmoid, while 1 patient out of 10 post-traumatic cases had a leak at the level of the sella. In all 20 patients, we repaired skull base defects by fixing grafting materials with Vivostat®. We have not had any complications. Vivostat® is a useful product in skull base repair and safe for the patients.
Vivostat® has been used as a sealant on body tissues with greater elasticity and more resistant allowing better and safer wound repair, especially in skull base surgery. In particular, its immediate polymerisation is very useful for an evaluation of the mechanical sealants in the closure of the skull base cerebrospinal fluid leak.
在许多外科手术中，有多种纤维蛋白衍生密封剂用作局部止血剂。纤维蛋白密封剂通常是非自体衍生物或动物衍生物，但Vivostat®除外，它是一种源自患者自身血液的自体纤维蛋白密封剂。
我们介绍了在巴勒莫索菲亚 - 塞尔维洛联合医院耳鼻喉科对20例患者进行颅底封闭手术时使用Vivostat®的经验。所有术后患者均采取头低脚高位48小时。取出鼻拭子后未发现任何鼻漏，我们通过计算机断层扫描检查了颅底缺损的密封性。
在总共20例患者中（10例创伤后患者和10例医源性漏液患者），10例创伤后患者中有9例在筛窦前后部之间的边界区域存在漏液，而10例创伤后患者中有1例在蝶鞍水平存在漏液。在所有20例患者中，我们使用Vivostat®固定移植材料修复颅底缺损。我们没有出现任何并发症。Vivostat®在颅底修复中是一种有用的产品，对患者安全。
Vivostat®已被用作身体组织的密封剂，这些组织具有更大的弹性和更强的耐受性，能够实现更好、更安全的伤口修复，尤其是在颅底手术中。特别是，其即时聚合对于评估颅底脑脊液漏封闭中的机械密封剂非常有用。
