Fibrin sealant in the United States: clinical use at the University of Virginia.

Fibrin sealant use in the United States has been limited because of the lack of a commercially available, government approved product. However, the significant need and usefulness of this material at the time of surgical operations has stimulated alternative sources of production. At the University of Virginia, the Blood Bank produces concentrated single donor or autologous fibrinogen for use with commercially available bovine thrombin in order to make fibrin sealant. The hemostatic and adhesive properties of fibrin sealant have been used since 1985 at this Center in a wide variety of operations with over 90% effectiveness. This chapter will review the development and role of this material in modern clinical surgery at this institution. The advantages, disadvantages, and never applications of this substance in various forms will be assessed. The role of fibrin sealant is increasing in this country and additional developmental work is continuing. The era of a commercially available product in the United States appears to be on the horizon.