Role of fibrin sealants in surgical procedures on patients with hemostatic disorders.

Fibrin sealants have until now been used to a very limited extent in patients with a bleeding diathesis. The authors have accumulated experience from 8 minor and 40 major surgical procedures, plus 10 circumcisions and 118 tooth extractions in 106 patients suffering from hemophilia A, B, or von Willebrand's disease. Most of the patients had the severe form of the disease. The authors were able to show a reduction of blood loss and of requirements for replacement therapy with factor concentrates. The literature on the application of fibrin sealants in this group of patients, which mainly deals with dental procedures, is reviewed and compared with data from the current study. The composition of the glue is of major significance and is discussed in detail.