Fibrin adhesive and its application in thoracic surgery.

Human fibrinogen cryoprecipitate has found wide application as a biologic tissue adhesive in thoracic and cardiovascular surgery. During 1979 and 1980 fibrin adhesive was applied in all surgical procedures involving persistent or recurrent pneumothorax and it was used prophylactically to cover large parenchymal defects following standard lung resections. The benefit of its application on pleura and lung tissue derives from added reinforcement of sutures and sealing of non-saturable defects. Twenty-one patients with recurrent spontaneous pneumothorax revealed a reduced average drainage period as compared to 15 non-glued cases with lesions of comparable size. Similarly, in 20 cases where tissue adhesive was applied to extensive pleural defects following segmental lung resection or lobectomy, suction drainage time was significantly less than in 11 cases of comparable, non-glued defects. Compared to 140 lung resections performed prior to the use of fibrin glue, these 20 cases were found to require the same average drainage time, although the extent of their lesions would otherwise have warranted longer periods of continued suction drainage.