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Fibrin glue is a sealant made from processed blood products that can be combined to simulate the final stage of coagulation. It can be used in a variety of surgical settings to seal wounds, including in ocular surgery, where suitable products for wound closure can be difficult to find. The legal status of fibrin glue varies by nation; in some regions it has regulatory approval and may be readily available, while in others it is only used in experimental settings. If it is an option for a procedure, a surgeon may discuss it with a patient when talking about various surgical approaches.
Two different products are combined in fibrin glue. The first is a mixture of fibrinogen and factor XIII, which can be blended with a thrombin-calcium mixture that acts as a catalyst. The mixture begins to clot, just as the blood does in the final stages of coagulation, forming a strong, elastic bond. This acts as a natural glue inside the body to stop bleeding, seal an incision, or act as an attachment, depending on how the surgeon is using the product.
One advantage of fibrin glue is that the body can break it down naturally when it is no longer needed, without leaving hazardous residue behind. The strength and flexibility make it suitable for a range of types of injuries, and it can reduce scarring. This may be an important consideration if scars are of cosmetic concern, but they can also be a problem internally, where fibrin glue may prevent adhesions and other problems caused by internal scars.
In microsurgery applications, fibrin glue can be particularly useful for controlling bleeding in the surgical field and sealing incisions with a minimum of scarring. Rather than placing sutures for a small incision, for instance, the surgeon could apply this bioadhesive product to hold the edges of the incision together while they heal. As the body replaces the glue with its own matrix of new tissue, it can break down the components and seal the site, leaving minimal scarring behind.
One potential concern with fibrin glue, as with other blood products, is the risk of transmissible diseases. Blood needs to be carefully screened before it can be used to make any products, in case a donor has hepatitis or another blood-borne disease that could be passed to recipients. Blood banks use a variety of screening techniques to eliminate high-risk donors and check blood once it is donated to confirm it is safe.