Summary
In wound repair, fibrin has a multiplicity of activities, some of which are intrinsic
to the protein itself and some attributable to other blood constituents associated
with the fibrin clot. Fibrin sealants, which have been approved for hemostasis in
the US and Europe, are occasionally used wounds to promote healing. However, inconsistency
exists in the literature regarding the benefit of these preparations in the healing
process. Morecrude fibrinogen preparations, such as cryoprecipitates made from the
patient’s own blood on location, appear from the literature to have better utility
in wounds than more purified fibrinogen preparations available through commercial
sources. These divergent outcomes are likely attributable to additional blood-derived
products being associated with cryo-precipitates compared to the relatively purified
commercial fibrinogen preparations. Clearly standard preparations and methods of application
of fibrin sealant need to be defined for each particular surgical setting to resolve
the many ostensible discrepancies in the current literature. A corollary is that different
fibrin sealant preparations are likely to be preferable for different clinical situations.
Keywords
Fibrin sealant - fibronectin - cell migration - wound healing
