Fibrin sealant patches: powerful and easy-to-use hemostats

Abstract

William D SpotnitzSurgical Therapeutic Advancement Center (STAC), Department of Surgery, University of Virginia Health System, Charlottesville, VA, USA Abstract: Fibrin sealant liquid was approved for use in the US in 1998 by the Food and Drug Administration as the first of a new generation of hemostats, sealants, and adhesives. The initial fibrin sealant liquid use in the country was limited by obstacles in the formulation's ease of use (usability). Specifically, it was associated with cumbersome preparation, including thawing, mixing, and applicator loading. Although these challenges have been addressed to some extent, a new generation of fibrin sealants in the form of patches has been introduced, boasting significant efficacy as well as elimination of the liquid preparation complexities. Additionally, the patches may provide enhancements in efficacy because they are easily combined with manual pressure to arrest bleeding. In addition, usability has been increased because they may be stored at room temperature and they are provided in packages ready for immediate use. This review will highlight the capabilities of the two Food and Drug Administration-approved fibrin sealant patches and review the recent literature on fibrin sealant patch use. Keywords: fibrin sealant, liquid, patches, hemostats, safety, efficacy, usability, cost