Fibrinogen-fibrin conversion and inhibition of fibrinolysis.

The fibrin adhesion technique is the imitation of the last step of the coagulation system. Fibrinogen is converted by thrombin into fibrin and stabilized by factor XIII. Fibrin sticks to the tissue and the tissue is adapted by syneresis. Local application of aprotinin to the thrombin solution is necessary in order to inhibit premature lysis of the fibrin film. This technique is now used in some selected cases in man such as fixation of cartilage, tendon, sealing of colonic anastomoses and preclotting of vessel grafts. An excellent hemostyptic effect of the fibrin glue in combination with absorbable collagen tampons was found. This combination technique is now used to seal parenchymatous organs and to stop hemorrhage in patients with defective hemostasis particularly those undergoing open heart surgery.