Fibrin sealants, such as, Quixil (Johnson & Johnson Wound Management, UK) are biological haemostatic agents derived from human plasma. Two components are mixed together on application; the first component contains fibrinogen and the second component is a solution of thrombin, and calcium required to activate coagulation. Their action imitates the final stages of the clotting pathway, which converts fibrinogen to fibrin. The resulting clot aids haemostasis and tissue sealing and is subsequently absorbed during wound healing. Therefore, any foreign body reaction or extensive fibrosis is avoided.
Fibrin sealants have not been studied well in thyroid surgery,24-26 but have been widely used in many areas of surgery to obtain haemostasis. They are easy to handle, rapidly absorbed, and have a haemostatic action independent of the general clotting mechanism.
They appear to have similar complication rates compared to conventional techniques and lead to lower drainage output after thyroidectomy.26
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