Fibrin and Thrombin Sealants in Vascular and Cardiac Surgery: A Systematic Review and Meta-analysis

WHAT THIS PAPER ADDS There have been few reviews and no meta-analyses assessing the effectiveness of fibrin and thrombin sealants in vascular and cardiac surgery. A qualitative review of fibrin sealants in vascular and cardiac surgery concluded that most studies on fibrin sealants in vascular and cardiac surgery showed a benefit on achieving homeostasis, yet individual study Results were not meta-analysed to allow effect estimation. There are still concerns regarding the adverse events associated with antigenicity of bovine thrombin or aprotinin used in the majority of commercially available fibrin sealants and the thrombogenicity associated with sealant use. This review explores the efficacy, as well as adverse effects, associated with newer and pre-existing fibrin sealants.