Accessibility / Report Error

Surgical adhesives


The authors have performed a literature review of surgical adhesives, such as cyanoacrylate, collagen gelatin, and fibrin glue. They have included different types of commercial and non-commercial fibrin sealants and have reported on the different components in these adhesives, such as fibrinogen, cryoprecipitate, bovine thrombin, and thrombin-like fraction of snake venom.

fibrin glue; surgical adhesives; collagen gelatin; cyanoacrylates; fibrinogen; cryoprecipitate; bovine thrombin; thrombin-like fraction; snake venom

Review article


I. A. THOMAZINI-SANTOS1,5 CORRESPONDENCE TO: I.A. Thomazini-Santos - Laboratório de Hemostasia da Divisão Hemocentro da Faculdade de Medicina de Botucatu, Distrito de Rubião Junior, Botucatu, São Paulo, Brasil. E-mail: , S. R. C. S. BARRAVIERA2,5, M. J. S. MENDES-GIANNINI3,5, B. BARRAVIERA4,5

1 Divisão Hemocentro, Faculdade de Medicina de Botucatu; 2 Departamento de Dermatologia e Radioterapia, Faculdade de Medicina de Botucatu; 3 Departamento de Análises Clínicas, Faculdade de Ciências Farmacêuticas de Araraquara; 4 Departamento de Doenças Tropicais e Diagnóstico por Imagem, Faculdade de Medicina de Botucatu and 5 Centro de Estudos de Venenos e Animais Peçonhentos - CEVAP, Universidade Estadual Paulista - UNESP, Botucatu, Estado de São Paulo, Brasil.

ABSTRACT: The authors have performed a literature review of surgical adhesives, such as cyanoacrylate, collagen gelatin, and fibrin glue. They have included different types of commercial and non-commercial fibrin sealants and have reported on the different components in these adhesives, such as fibrinogen, cryoprecipitate, bovine thrombin, and thrombin-like fraction of snake venom.

KEY WORDS: fibrin glue, surgical adhesives, collagen gelatin, cyanoacrylates, fibrinogen, cryoprecipitate, bovine thrombin, thrombin-like fraction, snake venom.


Sutures are a conventional way of uniting tissues and wound edges. They often become foreign bodies that may cause problems: fistula and granuloma formation due to a possible tissue incompatibility with suturing materials; parenchyma tissue sectioning; dehiscence when absorbable suturing materials show disintegration early; and tissue ischemia with resulting wound edge necrosis when a suture is too tight. Sutures may also take a long time to perform, especially in difficult anatomical areas. Research has been looking for ways to minimize this procedure constantly searching for an ideal adhesive that promotes firm tissue adhesion, hemostasis, no alteration in the healing process, and no carcinogenic or side effects. Several substances have been used, for instance, cyanoacrylates (12,17,29,35), which although being effective, present carcinogenic effect, toxicity, loss of bond strength in the presence of water, and tissue necrosis.

Collagen gelatin is another adhesive that has been available since 1979 (23). This substance includes formaldehyde and glutaraldehyde in the polymerizing agent (7).

One of the most studied adhesive agents is fibrin, which is originally made from plasma proteins and mimics the last physiological steps of the coagulation cascade, leading to the formation of a fibrin clot (27).

The use of fibrin as a surgical biological adhesive dates back to 1909 when Bergel (6) documented its hemostatic effect. In 1915, Grey (15) reported its use in liver and brain hemorrhage. In the 1940s, Young et al. (57) used fibrinogen, and Tarlow and Bernard (49) coagulated plasma, to unite peripheral nerves.

In 1944, Tridrick et al. (54) effectively mixed fibrinogen and thrombin for fixing skin grafts. Around the same time, Cronkite et al. (9) used thrombin and human fibrinogen mixed at the bleeding site during surgery to attain hemostasis. However, the concentrations of these substances were not sufficient, making this adhesive unstable and unacceptable to the scientific community.

After many studies, the effectiveness of fibrin sealant was significantly enhanced. In 1972, Matras et al. (31) developed a more concentrated form of fibrinogen. In later studies, Matras et al. (32) had encouraging results with fibrin glue in experimental small vessel microanastomoses, using only two sutures for approximation.

Fibrin adhesive has also been found effective in sealing splenic ruptures and tears in other visceral organs (30).

In 1976, Spangler et al. (45) began using fibrin glue in cardiac surgery. Around the same time, Bosch et al. (8) used a mixture of fibrin adhesive and bone fragments in orthopedic surgery.

Fibrin adhesives were composed of fibrinogen from human plasmas, bovine thrombin, calcium chloride, and aprotinin (an antifibrinolytic agent). These however were not approved by the Food and Drug Administration in the United States due to the risk of transmitting viral diseases, such as hepatitis and AIDS.

Autologous adhesives using fibrinogen from the patient's own blood was an alternative to avoid these problems. This minimized the risk of transmitting infectious diseases and allergic reactions (27); they cannot be used in emergency surgeries, only in elective and programmed surgical procedures.

Up until now, both commercial and "homemade" fibrin sealants have been used in a great variety of surgical procedures. In Europe, fibrin adhesive is used in 30% to 45% of cardiovascular and thoracic surgeries (39). Fibrin sealants have also been widely used in patients with coagulopathies.

Fibrin sealant may be used alone or with suture in cardiovascular surgeries, especially when vascular anastomosis is in a difficult anatomical area (3). It can also be used in heart valve implantations; synthetic vascular grafts; cardiovascular patches to avoid leakage from interstices; and the reduction of mediastinal drainage after cardiac surgeries. There are reports on fibrin sealant used in the repair of acquired ventricular septal defect (43), in aortic dissections and aneurysms (10), and in heparinized patients on extracorporeal circulation because it does not require a normal coagulation system and can be applied at room or body temperature (37).

Several beneficial effects have been reported on the application of fibrin sealant, such as a reinforcement of esophageal anastomoses; closure of bronchopleural fistulas (especially those less than 4 mm in diameter) (2); and endoscopic intrabronchial treatment by hemoptysis (4).

In gastrointestinal surgeries, fibrin sealant is mainly used to seal intestine anastomosis and liver biopsy; it is also used in hepatic laparoscopy (19). Fibrin sealant has also been successful in controlling bleeding from esophageal varices secondary to portal hypertension (33).

Several studies have documented a wide variety of additional uses of fibrin adhesive (27,44,46): for achieving hemostasis in patients with coagulation disorders (22); improving results following face lifts (11); repairing dural defects in craniofacial resections (53), assuring hemostasis following tooth extraction in anticoagulated patients (58); closing incisions after blepharoplasty (28); performing pancreaticojejunostomy (18); closing rectovaginal and other complex fistulas (1); treating pneumothoraces in premature infants(5); and closing multiple ventricular septal defects (24).

Fibrin adhesive has also been used as a carrier for other compounds, such as releasing antibiotics at the site of an infection (13,21,40,52); delivering chemotherapeutic agents to tumor cells (48); delivering growth factor for cartilage healing (16); and in the endothelialization of vascular grafts (14). Studies have also been published on bone induction using this sealant as a carrier for demineralized bone (36).

There are several applications for fibrin adhesive, but the use of human blood as one of its components has restricted its utilization due to the risk of transmitting blood-borne diseases.

In view of these adverse effects, in the late 1980's, a group of researchers from the Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University came up with the idea of substituting human fibrinogen for animal fibrinogen and bovine thrombin for a thrombin-like fraction of snake venom. This fraction, first reported by Nahas et al. (34) and isolated and characterized by Raw et al. (38), is capable of transforming fibrinogen into fibrin. This substitution is feasible because bovine thrombin, not specific to human fibrinogen, and the thrombin-like fraction act on the fibrinogen molecule similar to human thrombin, thus forming a network.

The first study substituted bovine thrombin for the thrombin-like fraction and combined it with cryoprecipitate fibrinogen from blood donors. This new adhesive was tested in the repair of Wistar rat sciatic nerves in comparative studies between the following groups: conventional suture, commercial adhesive made from human fibrinogen and bovine thrombin, and adhesive made from thrombin-like fraction. Iuan et al. (20) observed good hemostatic and adhesive properties of the new sealant, and good regeneration of the glued nerves. These results were similar to those using conventional suture and commercial adhesive.

In 1994, Leite et al. (25,26) used the adhesive made from thrombin-like fraction and bubaline fibrinogen in rat colon anastomosis. The authors evaluated three experimental groups composed of 50 animals each using fibrin adhesive as adjuvant. In Group 1(Control Group), intestine anastomosis was performed with 14 surgical stitches; in Group 2, 4 surgical stitches and fibrin glue; and in Group 3, 6 stitches and fibrin glue. Animals (3 groups) were sacrificed and evaluated on the 4th, 7th, 14th, and 21st days postoperative. There was a progressive increase in tensile strength from the 7th day postoperative in all groups. The authors observed that the fibrin glue shows good hemostatic effect; they also observed that the groups using fibrin glue showed the same tensile strength as the control group.

In the same year, Viterbo et al. (56) evaluated the efficacy of this product using bubaline, equine, bovine, and human fibrinogens. The authors repaired Wistar rats sciatic nerves using the different components of this adhesive and compared their results with the traditional fibrin adhesives Tisseel® or Tyssucol®, and with conventional neurorrhaphy with 10-0 mononylon. Ninety-two male rats weighing between 200 and 250 grams were divided into seven groups. Thirty days later, the animals were sacrificed and the nerves submitted to adhesiveness tests. The following results were obtained: in the bubaline group, 100% adhesion; in groups Tyssucol® and human, 90.91% adhesion; in the suture group, 90% adhesion; and in the bovine and equine groups 69.23% and 46.15% adhesion, respectively. Statistical analysis using the Test of Proportions with mononylon considered the standard showed that the suture, Tyssucol®, human, and bubaline groups were similar and superior to the others The Tyssucol® group showed the highest tensile strength (measured in grams weight). The authors concluded that the fibrin adhesive from snake venom using bubaline fibrinogen is a major alternative in repairing peripheral nerves.

In 1998, Thomazini-Santos et al. (50) made a comparative study between bovine, equine, ovine, and bubaline cryoprecipitates to find out which of these had the highest fibrinogen levels and efficacy. Cryoprecipitate from animal species was obtained using the same procedures as for human cryoprecipitate. The results of this study demonstrated that bubaline cryoprecipitate showed higher fibrinogen level than the other animal species.

In the same year, Sartori Filho et al. (42) compared the advantages and disadvantages of the snake venom fibrin glue and conventional suture in testicular biopsy of rams. The authors concluded that this new biological adhesive is easily applied; shows fast, good-quality healing; and reduces postoperative morbidity.

In 1999, Stolf (47) performed a pioneer study in humans. He evaluated the adhesive and hemostatic properties of the snake venom fibrin glue in skin surgery and compared the results obtained with fibrin glue and 5-0 nylon. Twenty-one patients with nose skin tumors participated in this study. After tumor removal, the excised areas were covered with skin removed from the right and left nasolabial folds. Skin grafting of the right nasolabial fold was made using fibrin glue, the left was sutured. The comparative study of both areas in the same patient showed erythema and edemas on the sutured areas, and dehiscence and serum-hemorrhagic exudation on the glued area 48 hours after surgery. Cosmetic evaluation of scar formation was excellent for the glued area and good for the sutured area; patients did not show any local or systemic toxic effects. The results showed that snake venom fibrin glue showed complete adhesion in 71.4% and partial adhesion in 28.6% of the patients, making the new adhesive a valuable alternative in skin surgery.

In 2000, Reis (41) studied peripheral nerve repair using autologous nerve grafting, comparing two techniques: coaptation with snake venom fibrin glue and epineural terminal lateral neurorrhaphy. This was performed in rats studying the possibility of regenerating axons from an intact nerve (n. vagus) to grow into a nerve graft (n. fibularis). Grafts were harvested after 8 and 12 weeks post-surgery and processed for light and transmission electron microscopy. In most cases, neurorrhaphy produced nerve fiber regeneration; regeneration rate was higher in fibrin glue coapted grafts.

In the same year, Vicente et al. (55) compared epineural suture and snake venom fibrin glue coaptation to repair Wistar rat sciatic nerves. This revealed that although no statistically significant differences were seen between the two techniques, regeneration was better with fibrin glue than with suture.

In 2001, Thomazini-Santos (51) studied the addition of antifibrinolytic agents to the fibrin adhesive made of snake venom and animal fibrinogen on wound edge coaptation in rats. Although statistically significant differences were not observed between experimental and conventional suture groups, tensile strength values were higher using fibrin adhesive. Histopathological analysis demonstrated that the fibrin glue + tranexamic acid gave the best wound edge coaptation.

Additional studies have been performed with encouraging results. It is important to emphasize that fibrin glue derived from snake venom can be used as adjuvant and sealant, rather than being just another alternative for traditional suture. This adhesive is a new option that does not use human blood, has good adhesive capacity, and is of low cost.

Received 25 May 2001

Accepted 25 May 2001

  • 1
    ABEL ME., CHIU YSY., RUSSELL TR., VOLPE, PA. Autologous fibrin glue in the treatment of rectovaginal complex fistulas. Dis. Colon Rectum, 1993, 36, 447-9.
  • 2
    ANTONELLI M., CICCONETTI F., VIVINO G., GASPARETTO, A. Closure of tracheoesophaseal fistula by bronchoscopic application of fibrin glue and decontamination of the oral cavity. Chest, 1991, 100, 578-9.
  • 3
    BAKER JM., SPOTNITZ WD., NOLAN SP. A technique for spray application of fibrin glue during cardiac operations. Ann. Thorac. Surg., 1987, 43, 564-5.
  • 4
    BENSE L. Intrabronchial selective coagulative treatment of hemoptysis. A report of tree cases. Chest, 1990, 97, 990-6.
  • 5
    BERGER JT., GILHOOLY J. Fibrin glue treatment of persistent pneumothorax in a premature infant. J. Pediatr., 1993, 122, 958-60.
  • 6
    BERGEL S. Uber Wirkungen des fibrins. Dtsh. Med. Wochenschr., 1909, 35, 633.
  • 7
    BONCHECK LI., BRAUNWALD NS. Experimental evaluation of a cross-linked gelatin adhesive in gastrointestinal surgery. Ann. Surg., 1967, 165, 420-4.
  • 8
    BOSCH P., BRAUN F., ESCHBERGER J., KOVAC W., SPANGLER HP. Die beeinflussung der knochenheilung durch horchkonzentrierts fibrin experimentelle untersuchung an kaninchen. Arch. Ortop. Unfall. Chir., 1977, 89, 259.
  • 9
    CRONKITE EP., LOZNER EL., DEAVER JM. Use of thrombin and fibrinogen in skin grafting. J. Amer. Med. Assoc., 1944, 124, 976-8.
  • 10
    DOTTORI V., SPAGNOLO S., PASSERONE G., LIJOR A., BARBERIS L., AGNOSTINI M., DE GAETANO G., PARODI E., MACCARIO M., FUMAGALLI ED. Ten years of surgery of aortic dissections and aneurysms. Clinical experience and original contributions. Minerva Cardioangiol., 1992, 40, 431-6.
  • 11
    FLEMMING I. Fibrin glue in faces lifts. Facial Plastic. Surg., 1992, 8, 79-88.
  • 12
    FISCHL RA. An adhesive for primary closure of skin incisions. Plast. Reconstr. Surg., 1962, 30, 607-10.
  • 13
    GRECO F., DEPALMA L, SPAGNOLO N., ROSSI A., SPECCHIA N., GIGANTE A. Fibrin-antibiotic mixtures: an in vitro study assessing the possibility of using a biological carrier for local drug delivery. J. Biomed. Mat. Res., 1991, 25, 39-51.
  • 14
    GREISLER HP., CZIPERLE DJ., KIM DA., GARFIELD JD., PETSIKAS D., MURCHAN PM., APPLEGRE EO., DROHAN W., BURGESS WH. Enhanced endothelization of expanded polytetrafluoroethylene grafts by fibroblast growth factor type 1 pretreatment. Surgery, 1992, 112, 224-55.
  • 15
    GREY EG. Fibrin as a haemostatic in cerebral surgery. Surg. Gynecol. Obstet., 1915, 21, 452.
  • 16
    HASHIMOTO J., KUSOSAKA M., YOSHIYA S., KAZUSHI H. Meniscal repair using fibrin sealant and endothelial cell growth factor. Am. J. Sports Med., 1992, 20, 537-41.
  • 17
    HEALEY JR., SHEENA KS., GALLAGER HS., CLARK L., O'NEILL P. The use of a plastic adhesive in the technique of bronchial closure. Surg. Forum, 1962, 13, 153-5.
  • 18
    HIRAOKA T., KANEMITSU K., TSUJI T., SAITOH N., TAKAMORI H., AKAMINE T., MIYAUCHI Y. A method for safe pancreaticojejunostomy. Am. J. Surg., 1993, 165, 270-2.
  • 19
    ISHITANI MB., MCGAHREN ED., SIBLEY DA., SPOTNITZ WD., RODGERS BM. Laparoscopically applied fibrin glue in experimental liver trauma. J. Pediatr. Surg., 1989, 24, 867-71.
  • 20
    IUAN FC., THOMAZINI IA., GIANNINI MJSM., VITERBO F., TOSCANO E., MORAES RA., BARRAVIERA B. Reparation of peripheral nerves with fibrin glue prepared from snake venom. Preliminary reports. Rev. Paul. Med., 1995, 113, 1000-2.
  • 21
    KRAM HB., BANSUL M., TIMBERLAKE O., SHOLMAKER W. Antibacterial effects of fibrin glue and fibrin glue-antibiotics mixtures. Trans. Soc. Biomat., 1983, 12, 164.
  • 22
    KRAM HB., NATHAN RC., STAFFORD FJ., FLEMING AW., SHOEMAKER WC. Fibrin glue achieves hemostasis in patients with coagulation disorders. Arch. Surg., 1989, 124, 385-7.
  • 23
    LAURIAN C., GIGOU F., BICAL O., BARBAGELATA M., BACHET J., GOUDOT B., GUILMET D. Traitment chirurgical des dissections aortiques aigües par utilisation d'une colle biologique. J. Chir., 1979, 116, 143-8.
  • 24
    LECA F., KARAM J., VOUHE PR., KHOUR YW., TAMISIER D., BICAL O., DA CRUZ E., THIBERT M. Surgical treatment of multiple ventricular septal defects using a biologic glue. J. Thorac Cardiovasc. Surg., 1994, 107, 96-102.
  • 25
    LEITE CVS., NARESSE LE., SAAD LHC., THOMAZINI IA., BARRAVIERA B., KOBAYASI S. Cicatrização intestinal, efeito da cola de fibrina derivada do veneno de cobra na anastomose do cólon de ratos. In: CONGRESSO BRASILEIRO DE COLO-PROCTOLOGIA, 43, Recife, 1994. Resumos... Recife, 1994 117.
  • 26
    LEITE CVS., NARESSE LE., ARANTES HL., LOPES AF., THOMAZINI-SANTOS IA.,GIANNINI MJSM, MERCADANTE MC., BARRAVIERA B., KOBAYASI S. An evaluation by rat colon anastomosis of the efficacy of fibrin glue derived from snake venom. J. Venom. Anim. Toxins, 2000, 6, 180-93.
  • 27
    LERNER R., BINUR NS. Current research review - Current status of surgical adhesives. J. Surg. Res., 1990, 48, 165-81.
  • 28
    MANDEL MA. Minimal suture blepharoplasty: closure of incisions with autologous fibrin glue. Anesth. Plast. Surg., 1992, 16, 269-72.
  • 29
    MARABLE SA., WAGNER DE. The use of rapidly polymerizing adhesives in massive liver resection.Surg. Forum, 1962, 13, 264-6.
  • 30
    MARTINOWITZ U., SPOTNITZ WD. Fibrin tissue adhesives. Thromb. Haemostasis, 1997, 78, 661-6.
  • 31
    MATRAS H., DINGES HP., MONOLI B. Zur naktlosen interfarszikularen nerventransplantation in tiex experiment. Wien. Med. Wochenschr., 1972, 122, 517-23.
  • 32
    MATRAS H., CHIARI FM., BURKLE K., WICKENHAUSER J. Zur klebung von mikrogefassanastornosen. ANNUAL MEETING. DTSH GES F. PLAST UND WIEDERHERSTELLUNGSCHIRURGIE, 13, Stuttgart, 1977. Proceedings... Stuttgart: Thieme, 1977. 357.
  • 33
    NAGA M., GOUBRAN H., SAID M., BURNOUF T., BURNOUF-RADOSEVICH M. Endoscopic injection of biological or non-biological sealings for the initial control of bleeding oesophageal varices? New Engl. J. Med., 1993, 7, 834-8.
  • 34
    NAHAS L., DENSON KWE., MACFARLANE RG. A study of the coagulation action of eight snake venoms. Thromb. Diath. Haemorrh., 1976, 45, 205.
  • 35
    NATHAN HS., NACHLAS MM., SOLOMON RD., HALPERN BD., SELIGMAN AM. Nonsuture closure of arterial incisions using a rapidly polymerizing adhesive. Ann. Surg., 1960, 152, 648-59.
  • 36
    PINHOLT EM., SOLHEIM E., BANG G., SUDMANN E. Bone induction by composites of bioresorbable carriers and demineralized bone in rats. Surgery, 1992, 50, 1300-4.
  • 37
    PROWSE C. Pre-clinical and clinical assessment of Scottish national blood transfusion service fibrin sealant. Cambridge Symposium on Tissue Sealants: Current Practice, Future Uses, La Jolla, 1996
  • 38
    RAW I., ROCHA MC., ESTEVES MI., KAMIGUTI AS. Isolation and characterization of thrombin-like enzyme from the venom of Crotalus durissus terrificus. Braz. J. Med. Biol. Res., 1989, 19, 333.
  • 39
    RADOSEVICH M, GOUBRAN HA., BURNOF T. Fibrin sealant: scientific rationale, production methods, properties, and current clinical use. Vox Sang., 1997, 72, 133-43.
  • 40
    REDL H., SCHLAG G., STANEK G., HIRSCHL A., SEELICK T. In vitro properties of mixtures of fibrin seal and antibiotics. Biomaterial, 1983, 4, 29-32.
  • 41
    REIS FA. A comparative study of axonal sprouting from the vagus nerve in autologous grafts. J. Venom. Anim. Toxins, 2000, 6, 120.
  • 42
    SARTORI-FILHO R., PRESTES NC., THOMAZINI IA., MENDES-GIANNINI MJS., TOSCANO E., CANAVESI AMO., BARRAVIERA B. Use of fibrin glue derived from snake venom in testicular biopsy of rams. J. Venom. Anim. Toxins, 1998, 4, 23-35.
  • 43
    SEGUIN JR., FRAPIER JM., COLSON, P., CHAPTAL PA. Fibrin sealant for early repair of acquired ventricular septal defect.J. Thorac. Cardiovasc. Surg., 1992, 104, 748-51.
  • 44
    SIERRA DH. Fibrin sealant adhesive systems: a review of their chemistry, materials properties and clinical applications. J. Biomater. Appl., 1993, 309-52.
  • 45
    SPANGLER HP., BRAUN F., HOLLE I.. Die lokale anwendung von fibrinogen und kollagen zur blutstillung der herzchirurgie. Wien. Med. Wochenschr., 1976, 126, 86.
  • 46
    SPOTNITZ WD., FALSTROM JK., RODEHEAVER GT. The role of sutures and fibrin sealant in wound healing. Surg. Clin. North Am., 1997, 77, 651-69.
  • 47
    STOLF HO. The use of fibrin adhesive derived from snake venom and the evaluation of skin grafting using skin from the patient's nasolabial fold. J. Venom. Anim. Toxins, 1999, 5, 227.
  • 48
    SUGITACHI A., SHINDO T., KIDO T., KAWAHARA T. Bio-adhesiochemo-(BAC)- therapy. Proc. Am. Cancer Res., 1992, 33, 216.
  • 49
    TARLOV IM., BERNARD B. Plasma clot and silk suture of nerves. Surg. Gynecol. Obstet., 1943, 76, 366.
  • 50
    THOMAZINI-SANTOS IA., GIANNINI MJSM., TOSCANO E., MACHADO, PEA., LIMA CRG., BARRAVIERA B. The evaluation of clotting time in bovine thrombin, Reptilase®, and thrombin-like fraction of Crotalus durissus terrificus venom using bovine, equine, ovine bubaline and human crioprecipitates. J. Venom. Anim. Toxins, 1998, 4, 120-36.
  • 51
    THOMAZINI-SANTOS IA. Fibrin adhesive from snake venom: the effect of adding e-aminocaproic acid, tranexamic acid and aprotinin for coaptation of wound in rat skin incisions. J. Venom. Anim. Toxins, 2001, 7, 148-9.
  • 52
    THOMPSON DF., DAVIS TW. The addition of antibiotics to fibrin glue. South Med. J., 1997, 90, 681-4.
  • 53
    TOMA AG., FISHER EW., CHEESMAN AD. Autologous fibrin glue in the repair of dural defects in craniofacial resections. J. Laryngol. Otol., 1992, 106, 356-7.
  • 54
    TRIDRICK RT., WARNER ED. Fibrin fixation of skin transplants. Surgery, 1944, 15, 90.
  • 55
    VICENTE EJD., RODRIGUES AC., REIS FA., THOMAZINI-SANTOS IA. Suture versus fibrin adhesive: A comparative study in the peripheral nerve repair. In: WORKSHOP INTERNACIONAL DE MICROCIRURGIA DE MÃO, 5, Botucatu, 2000. Resumos... Botucatu , 2000 14p.
  • 56
    VITERBO F., IUAN FC., THOMAZINI IA., MENDES-GIANNINI MJS., FERRARI N., PALHARES A., BARRAVIERA B., ROSA G. Reparação de nervo periférico com cola de fibrina feita com veneno de cobra e fibrinogênio de búfalo, cavalo, boi e humano. Trabalho experimental em ratos. In: CONGRESSO SOBRE CIRURGIA EXPERIMENTAL RELACIONADO À CIRURGIA PLÁSTICA, Botucatu, 1994. Resumos... Botucatu, 1994 30.
  • 57
    YOUNG JZ., MEDAWAR PB. Fibrin suture of peripheral nerves. Lancet, 1940, 2, 126.
  • 58
    ZUSMAN SP., LUSTIG JP., NUN GB. Cost evaluation of two methods of post tooth extraction hemostasis in patients on anticoagulant therapy. Community Dent. Health, 1993, 10, 167-73.  
    I.A. Thomazini-Santos - Laboratório de Hemostasia da Divisão Hemocentro da Faculdade de Medicina de Botucatu, Distrito de Rubião Junior, Botucatu, São Paulo, Brasil.
  • Publication Dates

    • Publication in this collection
      08 Oct 2002
    • Date of issue
      Dec 2001


    • Received
      25 May 2001
    • Accepted
      25 May 2001
    Centro de Estudos de Venenos e Animais Peçonhentos - CEVAP, Universidade Estadual Paulista - UNESP Caixa Postal 577, 18618-000 Botucatu SP Brazil, Tel. / Fax: +55 14 3814-5555 | 3814-5446 | 3811-7241 - Botucatu - SP - Brazil