Fibrin glue

EDITOR, - H I Atrah's editorial on fibrin glue draws attention to the limited use of fibrinogen thrombin formulations in surgical procedures especially in Britain and the United States, even though such formulations have been commercially available since the early 1970s. The explanation forwarded for this is "concern about safety and unawareness of potential applications."

I do basic research into fibrinogen and have noticed more than 1000 publications in the Medline database referring to the clinical uses of fibrin sealants in a wide range of surgical procedures. Though many of these are single case reports or reports of small series of patients, most describe the suitability of fibrin sealant for the application under investigation (haemostasis, adhesion, air leakage, gut or nerve anastomosis, sealing, etc). Unfortunately, few controlled trials have included sufficient numbers of patients and used objective...