Life salvage with fibrin glue in three cases of exsanguinating hemorrhage.

Fibrin glue, although widely used in Europe for a decade, has not been commercially available in North America because its fibrinogen component is obtained from multiple, pooled, human blood donors with the subsequent increased risk of blood transmissible diseases. Techniques developed recently to isolate fibrinogen from single-donor plasma will circumvent these potential hazards. In Canada the use of fibrin glue has not been widespread even though biologic fibrin glue can be made from components readily available within most hospitals. Equal amounts of cryoprecipitate from fresh frozen plasma and bovine thrombin will combine within 2 minutes to form the fibrin glue. Simultaneous injections of each component at bleeding sites form a film of the glue that will effectively control even small arterial bleeding. The authors present three case reports to illustrate how use of the glue can save lives in cases of exsanguinating hemorrhage. They discuss the multiple applications of the fibrin glue which they believe will soon be part of the armamentarium of all Canadian surgeons.