FibrinSealants

Fibrin sealants are medical adhesives used to promote hemostasis and tissue sealing during surgery. They consist of a fibrinogen component and a thrombin component, which when combined in the operative field form a fibrin clot that adheres to tissue and seals surfaces. Many products also include calcium, factor XIII, and antifibrinolytic agents to improve clot stability and longevity.

These products may be derived from autologous plasma (the patient’s own blood), allogeneic human plasma, or animal sources. Early formulations used bovine thrombin, but modern preparations often use human thrombin to reduce immune reactions. There are also thrombin-free fibrin sealants and patches that incorporate a collagen or gelatin scaffold.

Fibrin sealants are typically supplied as two ready-to-use components that are applied sequentially with an applicator or spray device. Mixing triggers polymerization of fibrin and formation of a crosslinked clot at the target site, providing hemostasis and, in some cases, tissue adhesion or watertight sealing.

Used across specialties including cardiovascular, hepatic, neurosurgical, orthopedic, ENT, ophthalmology, and dentistry. They can reduce intraoperative blood loss, decrease postoperative drainage, and support anastomotic healing. They are often employed as an adjunct to sutures or staples.

Safety considerations include risks of infectious transmission (mitigated by donor screening and viral inactivation), hypersensitivity to components, and alloantibody formation with certain animal-derived thrombins. They are not substitutes for meticulous surgical technique or for use in infected fields, and cost may be a factor.