Two component preparation of fibrin glue and its clinical evaluation in split skin grafting

Background: Fibrin glue is an alternative to conventional suturing and stapling of skin grafts and has several advantages. It acts as a sealant and a hemostatic agent with an added adhesive property that has been reportedly used in many specialties with better outcomes. Objective: The objective was to study the effectiveness of fibrin glue in anchoring the split skin graft to the wound bed and to analyze the advantages, disadvantages, and outcome of using fibrin glue compared to suturing and stapling. Methodology: A total of 60 patients undergoing split skin grafting for various indications were studied. Each patient was used as both case and control, where fibrin glue was applied on one half and sutures and/or staples were applied on the other half of the same ulcer. Examination of the wound was conducted by two observers independently from the 3rd postoperative day at regular intervals onward and included inspection for the graft uptake, soakage, and infection and graded accordingly based on the three parameters. Results: Overall, graft uptake was better in fibrin glue study group. Furthermore, soakage and infection were less in fibrin glue study group when compared to the conventional suturing/stapling. No difference in infections rate was found among burns and postsurgical raw area patients. Conclusion: The use of fibrin glue is a simple, safe, and cost-effective method, with a rapid technique to fix the skin graft, avoid peroperative bleeding and postoperative collection, better uptake of graft, and better overall results.