Fibrin Glue Applications in Surgery, From Cardiovascular to Orthopedic Procedures


 

Introduction

Fibrin glue, a biological adhesive composed of fibrinogen and thrombin, has become an indispensable tool in modern surgical practice. By mimicking the final stages of the blood clotting process, it provides rapid hemostasis, promotes tissue adhesion, and facilitates wound healing. Its biocompatibility, versatility, and minimal risk of immune reactions make it a preferred choice across a broad spectrum of surgical specialties—from delicate cardiovascular interventions to complex orthopedic reconstructions.

The global fibrin glue market is likely to be valued at US$8.8 Bn in 2025, and reach US$13.8 Bn by 2032, driven by CAGR of 6.6% from 2025 to 2032. Fibrin glue, a type of biological adhesive composed of fibrinogen and thrombin, is widely used in surgical procedures to support surgical hemostasis, tissue adhesion, and sealing. This tissue glue is vital in cardiac, pulmonary, vascular, orthopedic, and neurosurgeries, as well as wound management and general surgery. 

Cardiovascular Surgery Applications

In cardiovascular surgery, bleeding control is paramount. Procedures such as coronary artery bypass grafting (CABG), valve replacements, and aortic dissection repairs often involve complex vascular structures where traditional sutures alone may be insufficient.

  • Hemostasis in Reoperations: Fibrin glue is particularly valuable in reoperative cardiac surgeries where scar tissue and fragile vessels increase bleeding risk. Clinical trials have shown that fibrin sealants can achieve hemostasis within minutes, significantly reducing the need for transfusions and lowering postoperative complications such as resternotomy.

  • Bypass Graft Sealing: It prevents leakage at graft anastomoses, improving graft patency and surgical outcomes.

  • Aortic Surgery: Used to reinforce sutures and seal dissections, reducing the risk of postoperative bleeding or aneurysm recurrence.

Key Benefit: Enhances surgical precision in high-risk, high-bleeding environments, contributing to shorter operative times and improved patient recovery.

Vascular Surgery Applications

In peripheral and microvascular procedures, fibrin glue ensures effective sealing in areas where sutures may compromise delicate tissues.

  • Endarterectomy and Bypass Procedures: Used to seal suture lines and prevent oozing.

  • Microvascular Anastomosis: Assists in connecting small vessels in reconstructive surgeries without damaging vessel walls.

Key Benefit: Promotes smooth blood flow and reduces the risk of postoperative thrombosis.

Pulmonary and Thoracic Surgery Applications

Fibrin glue plays a crucial role in preventing air leaks and managing bleeding in lung and chest surgeries.

  • Lung Resections: Applied to staple lines to prevent prolonged postoperative air leaks—a common cause of extended hospital stays.

  • Pneumothorax Repairs: Enhances sealing in minimally invasive thoracic surgeries.

Key Benefit: Reduces chest tube duration, lowers infection risk, and accelerates patient discharge.

Neurosurgical Applications

The brain and spinal cord require meticulous surgical handling due to their sensitivity and limited regenerative capacity.

  • Dural Sealing: Prevents cerebrospinal fluid (CSF) leakage after craniotomy or spinal surgery.

  • Tumor Resections: Controls bleeding in highly vascularized brain tumors while minimizing mechanical trauma.

Key Benefit: Offers watertight closure, reducing postoperative complications like meningitis.

Gastrointestinal and General Surgery Applications

In gastrointestinal surgeries, fibrin glue provides both sealing and reinforcement.

  • Anastomotic Reinforcement: Strengthens sutures in bowel resections, lowering leak rates.

  • Liver and Spleen Trauma: Controls diffuse bleeding from friable parenchymal tissue.

  • Hernia Repairs: Serves as a mesh fixation method, reducing postoperative pain compared to traditional suturing.

Key Benefit: Enhances surgical safety, especially in minimally invasive and laparoscopic approaches.

Orthopedic Surgery Applications

Orthopedic procedures often involve significant bleeding from bone surfaces and surrounding soft tissues.

  • Joint Replacements: Controls bleeding in knee and hip arthroplasties, improving visualization during surgery.

  • Fracture Fixations: Seals bleeding bone ends and secures bone grafts.

  • Spinal Surgeries: Reduces blood loss during decompression or fusion procedures.

Key Benefit: Promotes bone healing while minimizing postoperative swelling and hematoma formation.

Plastic and Reconstructive Surgery Applications

Aesthetic and reconstructive procedures demand precision and minimal scarring.

  • Skin Grafting: Improves graft adherence and survival rates.

  • Flap Surgeries: Secures tissue flaps without excessive suturing, enhancing blood supply preservation.

Key Benefit: Provides strong adhesion with better cosmetic outcomes.

Advantages Across Surgical Specialties

  • Biocompatibility: Minimizes immune response.

  • Rapid Action: Clot formation within seconds to minutes.

  • Versatility: Applicable in both open and minimally invasive procedures.

  • Reduced Complications: Lowers risk of infections, leaks, and hematomas.

Future Outlook

The role of fibrin glue is set to expand with advancements in recombinant production, nanotechnology-based delivery systems, and integration into regenerative medicine. Its potential as a scaffold for stem cells and drug delivery vehicle opens new possibilities in tissue engineering and chronic wound care.

Conclusion

From life-saving cardiovascular surgeries to precision-driven orthopedic reconstructions, fibrin glue has proven to be a game-changing surgical tool. Its ability to combine effective hemostasis, strong tissue adhesion, and minimal invasiveness makes it indispensable across diverse specialties. As surgical technology evolves, fibrin glue will continue to be at the forefront of innovations aimed at improving patient safety, reducing recovery times, and enhancing overall surgical outcomes.

𝐄𝐱𝐩𝐥𝐨𝐫𝐞 𝐭𝐡𝐞 𝐋𝐚𝐭𝐞𝐬𝐭 𝐓𝐫𝐞𝐧𝐝𝐢𝐧𝐠 𝐑𝐞𝐩𝐨𝐫𝐭: 

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