Decreased wound contraction with fibrin glue--treated skin grafts
D. M. Brown, B. R. Barton, V. L. Young and B. A. Pruitt
Division of Plastic Surgery, Washington University School of Medicine, St Louis, Mo.
Skin grafts can be used effectively to inhibit wound contraction. A
critical element of this inhibition is the adherence of the graft to the
wound bed. Fibrin glue has been shown to increase the adherence of skin
grafts to wound beds. We therefore devised an experiment to determine the
effect of fibrin glue on skin graft inhibition of wound contraction. Two
2.5 x 2.5-cm full-thickness defects were created on the dorsa of 15
Sprague-Dawley rats. Thirty partial-thickness grafts were harvested from
isogeneric donor animals using a brown dermatome. Prior to grafting, one
full-thickness defect, each animal received 0.2 mL of fibrin glue (Immuno
AG, Vienna, Austria). The adjacent wound served as the control and received
0.2 mL of normal saline. Grafts were applied, sutured, and protected with
an occlusive dressing. The size of graft sites treated with fibrin glue or
normal saline was determined at the time of graft application and
thereafter at 3-day intervals for 21 days using standardized photographic
techniques. The percentage of change from initial wound size at each point
was recorded for each group. Graft sites treated with fibrin glue
contracted less than the controls from the ninth postgraft day to the
completion of the study. The mechanism by which fibrin glue inhibits wound
contraction may be related to increased adherence of grafts to the
underlying wound bed. As an adjunct in skin grafting, fibrin glue may offer
certain advantages that are not achieved by suturing alone.
