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J Am Acad Orthop Surg, Vol 17, No 12, December 2009, 727-736.
© 2009 the American Academy of Orthopaedic Surgeons
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The Role of Fibrin Sealants in Orthopaedic Surgery

R. Justin Thoms, MD and Scott E. Marwin, MD

Perspectives on Modern Orthopaedics articles provide an objective appraisal of new or controversial techniques or areas of investigation in orthopaedic surgery.

Dr. Thoms is in practice at Lawrence & Memorial Hospital, New London, CT. Dr. Marwin is Associate Professor, Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY.

Dr. Marwin or a member of his immediate family is a member of a speakers’ bureau or has made paid presentations on behalf of Smith & Nephew; serves as a paid consultant to or is an employee of Smith & Nephew; serves as an unpaid consultant to Symmetry Medical; and has received nonincome support (such as equipment or services), commercially derived honoraria, or other non–research-related funding (such as paid travel) from Ethicon. Neither Dr. Thoms nor a member of his immediate family has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article.

Reprint requests: Dr. Thoms, Seacoast Orthopaedic Surgery, Suite 305, 495 Route 184, Groton, CT 06340.

Blood conservation, specifically the avoidance of allogeneic blood transfusion, is becoming an important aspect of preoperative planning and intraoperative decision making in orthopaedic surgery. Knee and hip arthroplasty, as well as certain spine procedures, place patients at risk of significant blood loss. Fibrin sealants are topically applied hemostatic agents that reduce the time required to achieve hemostasis as well as the volume of blood loss. Fibrin sealants may provide additional benefits beyond hemostasis, such as improvements in wound healing and postoperative range of motion as well as lower rates of wound infections.






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