International Journal of Adhesion & Adhesives 18 (1998) 345— 349
Effective application of fibrin sealant using a spray device
with a double-tube structure
Nobuto Fukunaga, Takanori Uchida, Hiroshi Kaetsu,* Katsumi Kawakami,
Yoshimitsu Ishihara, Akinobu Funatsu
The Chemo-Sero-Therapeutic Research Institute, 1-6-1 Okubo, Kumamoto 860-8568, Japan
Accepted 11 March 1998
Abstract
We developed a new device for applying a fibrin sealant to increase the strength of surgical seals. In the present study, the sealing
effectiveness of fibrin sealant, using this newly developed spraying technique, was compared with conventional sequential or
simultaneous applications of sealant. Sealing effectiveness of the three methods was evaluated by applying sealant to pinholes in
plastic caps and measuring the amount of pressure necessary to rupture the seals at various intervals following application. When the
spray application method was used, the pressure needed to burst the seal was higher than with either the sequential or simultaneous
method. It was also determined that only 30—70% of the sealant was utilized when it was applied to a slanted surface using the two
conventional methods while almost all of the sealant was utilized with the new spray technique. The results of this study indicate that
the new spray device will provide the most effective means to apply fibrin as a surgical sealant. 1998 Elsevier Science Ltd. All rights
reserved.
Keywords: A. Sealants; D. Adhesion in surgery and medicine; D. Biological adhesion; Spray application
1. Introduction
Fibrin sealant (also referred to as fibrin glue) is a com-
plex, plasma-derived product which is increasingly used
as a biodegradable tissue adhesive or sealant to stop or
control bleeding or to provide a barrier to air and fluid
during many surgical situations [1]. This product mimics
the last step of the blood coagulation cascade [2]
through the proteolysis of fibrinogen by thrombin which
leads to the formation of a semirigid fibrin clot. A fibrin
clot, which consolidates and adheres to the application
site, acts as a fluid-tight agent, able to hold tissues or
materials in a required configuration, while also exhibi-
ting hemostatic properties. In contrast to synthetic ad-
hesives (e.g. cyanoacrylate derivatives or gelatin—resor-
cinol—formaldehyde composite), plasma-derived fibrin
sealant has the significant advantage of being biocompat-
ible and biodegradable without inducing inflammation,
*Corresponding author. Tel.: 0081 963442189; fax: 0081 963449234;
e-mail: QYN00365@niftyserve.or.jp.
foreign-body reactions, or extensive fibrosis. For these
reasons, many surgeons regard fibrin sealants as ideal
operative hemosealants. In Europe, Japan, and Canada,
where they are licensed, industrial fibrin sealants have
been shown to be valuable and versatile topical tissue
adhesives of particular benefit in many surgical applica-
tions [3].
Almost all current formulations of fibrin sealant have
two components (fibrinogen and thrombin solutions),
analogous to epoxy resin-catalyst adhesives. The applica-
tion devices are designed to mix the fibrinogen and
thrombin components, either just prior to contact with
tissue or on the tissue itself [4]. The fibrin sealant can be
applied in the following ways: (1) sequential application,
(2) simultaneous application, and (3) spray application.
The simplest means of application (sequential applica-
tion) involves the sequential delivery of the two compo-
nents, fibrinogen first, via two separate and independent
syringes to the repair site. In simultaneous application,
a specially designed dual-syringe delivery device is often
used, which consists of a clip for two identical syringes,
a plunger holder for simultaneous operation of two
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