Skin grafting with fibrin glue in burns

Summary In an attempt to obtain better function and appearance minimize blood loss and increase graft survival with minimal postoperative care, deep burns are treated by applying the fibrin glue to difficult recipient sites. A two-component fibrin sealant is used, fibrinogen made from pooled human plasma and bovine thrombin (Tissucol, Immuno AG, Vienna, Austria). The fibrin sealant is described as well as the technique used to seal the skin grafts in 15 patients (18 procedures). Indications for graft sealing are limited to grafts over areas subject to movement (joints, face, neck, hands) and to non-meshed grafts for cosmetic reasons. This clinical experience demonstrates several advantages of sealing skin grafts on burn wounds: hemostasis, early adherence and wound healing are improved; better cosmetic results are obtained with sheet grafts on the face and neck; operating time is reduced; no special dressings are required; physiotherapy starts after 24 h; the period of rehabilitation is reduced as well as the incidence of secondary procedures.