Review Of Literature Thrombin

The potential use of purified thrombin in the clinic as a haemostatic agent has resulted in the work of isolation and purification of pro-thrombin and thrombin. The initial preparations were made in 1933 by Mellanby16 and, later, purified in 1938 by Seegers et al.17,18 and his co-workers. They calibrated and standardised the potency of the thrombin, known as the Iowa unit. Seegers etal.17,18 made the preparation called Thrombin Tropical. According to them, to apply thrombin to the bleeding surfaces a spray is useful, but a syringe and a fine needle are generally sufficient to flood the surface, with gentle rubbing with the gloved finger. A large group of 102 cases was used for testing, to control bleeding from donor skin graft sites. It was found to be of special use in split-thickness skin grafts. In a total of 78 split thickness-grafting operations of this type, the results were very good. In 40 cases, complete haemostasis was obtained in a few minutes. In 32 cases, there was immediate cessation of oozing. During cholecystectomy, persistent oozing from gall-bladder bed is occasionally very difficult to control. The same author used it in two cases in which sutures were ineffectual, and a prompt check on bleeding was obtained. This preparation was used for mucocutaneous margins, haemorrhoidec-tomy operations, oozing from mastectomy skin flaps, and cases of delayed postoperative bleeding. There was neither any evidence of local irritation nor hypersensitive reaction, despite repeated use.

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