Karl H. Siedentop

Autologous fibrin tissue adhesive

Various methods of making fibrin tissue adhesive from a patients own blood were evaluated. The method using ammonium sulfate for fibrinogen preparation produced the greatest bonding strength.

Extended experimental and preliminary surgical findings with autologous fibrin tissue adhesive made from patient's own blood

A surgical tissue adhesive can be made from the patients own blood. We have been refining the procedures for manufacturing autologous fibrin tissue adhesive to facilitate its use in the operating room and to increase its bonding strength. Fibrin tissue adhesive efficacy depends on fibrinogen concentration. We found that fibrinogen precipitation using the ammonium sulfate method produced the highest concentration. Bonding power was compared with that of the commercial glue 10 minutes and 30 minutes after glueing two pieces of 1 x 1 cm2 human dura together. Bonding strength of the autologous product was close to that of the commercial product. Comparisons of fibrinolysis inhibition time of autologous fibrin tissue adhesive and commercial glue in experiments on rats over a period of one hour to six days after subcutaneous injection are described.

Autologous fibrin tissue adhesive: Factors influencing bonding power†‡

Bonding power of Autologous Fibrin Tissue Adhesive (AFTA) is directly related to its fibrinogen concentration. By increasing the ammonium sulfate concentration 100% during fibrinogen precipitation, the bonding power of two glued 1‐cm2 pieces of human dura almost doubled. No relationship between blood fibrinogen level and bonding power was demonstrated. Comparing AFTA with Fibrin Sealant, the commercial fibrin tissue adhesive, shearing strength between two glued pieces of human dura with AFTA was less 10 minutes and greater 30 minutes after gluing. Gluing a TORP (Richards) to a 1‐cm2 piece of human dura yielded generally somewhat greater bonding power when using Fibrin Sealant.

Experimental Use of Fibrin Tissue Adhesive in Middle Ear Surgery

The biocompatibility of a new tissue adhesive was tested. Its major advantages are adhesions, hemostasis, and the promotion of wound healing. In experimental surgery on 43 middle ears of chinchillas, documented by histological evidence obtained 45 days after operation, the validity of the following two hypotheses was established.

Autologous fibrin tissue adhesive biodegration and systemic effects

A series of experiments was conducted to investigate the rate of Autologous Fibrin Tissue Adhesive (AFTA) degradation by the fibrinolysis inhibitor, epsilon amino caproic acid (EACA). The duration of AFTA clots in vitro, subcutaneous, and in the middle ear was prolonged for a time interval that was proportional to the concentration of EACA in Component II of the adhesive. No toxic reactions were observed in the middle or inner ear. Systemic pathology (thrombosis or emboli) could not be related to the presence of EACA applied in the middle ear or directly into the blood stream at concentrations (mg/kg body weight) up to 1,500 times that expected to occur during surgery on humans.

Fibrin tissue adhesive and autologous concha cartilage for reconstruction of the posterior-superior canal wall of the chinchilla middle ear.

Hypothesis: We conducted this study to prove that fibrin tissue adhesive (FTA) is safe, efficacious, biocompatible, and readily biodegradable with no deleterious side effects for fixation of a cartilage graft to bone along the chinchilla canal wall. Methods: A posterior–superior canal defect was created in 12 chinchillas. The canal walls of six chinchillas were closed with autologous concha cartilage alone, whereas the canal wall of the remaining six animals were closed with cartilage in conjunction with fibrin tissue adhesive. Results: Animals were killed 8 weeks postoperatively. Three of six cartilage grafts were displaced in the graft alone group, whereas all six grafts in the cartilage with FTA group healed without displacement. Conclusion: Fibrin tissue adhesive was found to be effective, biocompatible, biodegradable, and without any deleterious side effects for reconstruction of the superior–posterior canal wall of chinchillas.