조직 접착제를 이용한 유리 피부 이식술 - 임상적, 조직병리학적 고찰 -

FREE SKIN GRAFTING WITH FIBRIN ABHESIVE - CLINICAL AND HISTOPATHOLOGIC REVIEWS -

A fibrin adhesive have been widely used in oral and maxillofacial surgery for microvascular anastomosis, autogenous chip bone grafts, many kinds of soft tissue surgery (vestibuloplasty, bleeding control after extraction, primary healing by covering of suture of a gum after the extirpation of large cysts). There are two principal components in adhesive systems biologically: lyophilized human fibrinogen and bovine thrombin. The fibrinogen component contains coagulation factor XIII and enhance the initial wound healing, which polymerizes soluble fibrin monomers into an insoluble clot. The thrombin is dissolved in a solution of calcium chloride to provide the second component. We applied fibrin adhesive, Beriplast (Behring, Behringwerke AG, D-3350, Marburg, FRD), to 4 patients for fixation of free skin grafting donors who had facial scar around eye, nose, mouth corner which received from accidents, or burn. We have experienced initial accelerated graft fixation between donor and recipient sites with no additional fixation. And It's made easy bleeding control and easy manipulation during operation. But two cases showed partial hypertrophic scar engrowth in above 3 months follow up, but no significant. Histopathological reviews in general were showed similar scar findings such as abundant collagen bundles in H&E, M/T stain, but slight positive signs in elastic and collagen antibody immunopathologic findings in hypertrophic scar cases.