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THE USE OF FIBRIN ADHESIVE DERIVED FROM SNAKE VENOM AND THE EVALUATION OF SKIN GRAFTING USING SKIN FROM THE PATIENT’S NASOLABIAL FOLD

THESIS: H. O. Stolf submitted this thesis for his Doctor of Philosophy degree in Dermatology publicly examined at the Escola Paulista School of Medicine, UNIFESP, São Paulo, Brazil in 1998.

Advisor: Profa. Dra. Neuza Lima Dillon

ABSTRACT. Fibrin adhesive derived from snake venom mimics the last steps of the blood coagulation. Bubaline fibrinogen interacts with the thrombin-like fraction from snake venom, releasing a monomeric fibrin. This, in the presence of factor XIII and calcium, transforms into a polymeric substance with adhesive properties. This biological glue unites wound surfaces and assists in hemostasis. This study evaluates the adhesive and hemostatic properties of this new glue in skin surgery. It also compares the cosmetic results obtained with fibrin glue and 5-0 nylon. Twenty-one male and female Caucasian patients (mean age 64 years) with skin tumor participated in this study. After tumor removal, the excised areas were covered with skin removed from the right and left nasolabial folds. Skin grafting of the right nasolabial fold was made using fibrin glue, while the left nasolabial fold was sutured. The comparative study of both areas in the same patient showed erythema and edemas on the sutured areas, while dehiscence and serum-hemorrhagic exudation were seen on the glued areas 48 hours after surgery (Wilcoxon's test). On the seventh day after surgery, erythema and irregular contour at the incision site were seen on the sutured areas, while there was dehiscence on the glued area (Wilcoxon's test). The cosmetic evaluation of the scar formation was excellent for the glued area and good for the sutured area. The patients did not show any local or systemic toxic effects. The results show that fibrin glue derived from snake venom had a total adhesive capacity in 71.4% of the patients and a partial capacity in 28.6% of the patients, which makes this glue a valuable alternative method for skin surgery.

CORRESPONDENCE TO:

H. O. STOLF – Departamento de Dermatologia. e Radioterapia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Distrito de Rubião Junior , s/n, 18618-000, Botucatu, São Paulo, Brasil.

Publication Dates

  • Publication in this collection
    17 Sept 1999
  • Date of issue
    1999
Centro de Estudos de Venenos e Animais Peçonhentos - CEVAP, Universidade Estadual Paulista - UNESP Caixa Postal 577, 18618-000 Botucatu SP Brazil, Tel. / Fax: +55 14 3814-5555 | 3814-5446 | 3811-7241 - Botucatu - SP - Brazil
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