INTRODUCTION: There are many fibrin-derived sealants used as topical haemostatic agents in many surgical procedures. Fibrin sealants are usually non-autologous derivatives or animal derivatives, with the exception of Vivostat®, an autologous fibrin sealant derived from patients own blood. MATERIALS AND METHODS: We present our experience on the use of Vivostat® in skull base closures in 20 patients operated at the Otorhinolaryngology Unit of the Hospital Ospedali Riuniti Villa Sofia - Cervello of Palermo. All postoperative patients were placed in an anti-trendeleburg position for 48 hours. After removal of the nasal swabs we did not find any rhinorrhea and we checked the tightness of the skull base defect with computed tomography. RESULTS: On a total of the 20 patients (10 post-traumatic and 10 with iatrogenic leaks), 9 out of 10 post-traumatic cases had a leak in the border area between the anterior and posterior portion of the ethmoid, while 1 patient out of 10 post-traumatic cases had a leak at the level of the sella. In all 20 patients, we repaired skull base defects by fixing grafting materials with Vivostat®. We have not had any complications. Vivostat® is a useful product in skull base repair and safe for the patients. CONCLUSION: Vivostat® has been used as a sealant on body tissues with greater elasticity and more resistant allowing better and safer wound repair, especially in skull base surgery. In particular, its immediate polymerisation is very useful for an evaluation of the mechanical sealants in the closure of the skull base cerebrospinal fluid leak.
INTRODUCTION: There are many fibrin-derived sealants used as topical haemostatic agents in many surgical procedures. Fibrin sealants are usually non-autologous derivatives or animal derivatives, with the exception of Vivostat®, an autologous fibrin sealant derived from patients own blood. MATERIALS AND METHODS: We present our experience on the use of Vivostat® in skull base closures in 20 patients operated at the Otorhinolaryngology Unit of the Hospital Ospedali Riuniti Villa Sofia - Cervello of Palermo. All postoperative patients were placed in an anti-trendeleburg position for 48 hours. After removal of the nasal swabs we did not find any rhinorrhea and we checked the tightness of the skull base defect with computed tomography. RESULTS: On a total of the 20 patients (10 post-traumatic and 10 with iatrogenic leaks), 9 out of 10 post-traumatic cases had a leak in the border area between the anterior and posterior portion of the ethmoid, while 1 patient out of 10 post-traumatic cases had a leak at the level of the sella. In all 20 patients, we repaired skull base defects by fixing grafting materials with Vivostat®. We have not had any complications. Vivostat® is a useful product in skull base repair and safe for the patients. CONCLUSION: Vivostat® has been used as a sealant on body tissues with greater elasticity and more resistant allowing better and safer wound repair, especially in skull base surgery. In particular, its immediate polymerisation is very useful for an evaluation of the mechanical sealants in the closure of the skull base cerebrospinal fluid leak.
Authors: Valerie J Lund; Heinz Stammberger; Piero Nicolai; Paolo Castelnuovo; Tim Beal; Alfred Beham; Manuel Bernal-Sprekelsen; Hannes Braun; Paola Cappabianca; Ricardo Carrau; Luigi Cavallo; George Clarici; Wolfwang Draf; Felice Esposito; Juan Fernandez-Miranda; Wytske Fokkens; Paul Gardner; Verena Gellner; Henrik Hellquist; Phillipe Hermann; Werner Hosemann; David Howard; Nick Jones; Mark Jorissen; Amin Kassam; Daniel Kelly; Senta Kurschel-Lackner; Samuel Leong; Nancy McLaughlin; Roberto Maroldi; Amir Minovi; Michael Mokry; Metin Onerci; Yew Kwang Ong; Daniel Prevedello; Hesham Saleh; Dharambir S Sehti; Daniel Simmen; Carl Snyderman; Auturo Solares; Magaret Spittle; Aldo Stamm; Peter Tomazic; Matteo Trimarchi; Frank Unger; Peter-John Wormald; Adam Zanation Journal: Rhinol Suppl Date: 2010-06-01
Authors: Gustavo Hadad; Luis Bassagasteguy; Ricardo L Carrau; Juan C Mataza; Amin Kassam; Carl H Snyderman; Arlan Mintz Journal: Laryngoscope Date: 2006-10 Impact factor: 3.325