Human fibrinogen with thrombin (VeraSeal), topical surgical sealant kit: profile, composition and research
Reference page for Human fibrinogen with thrombin (VeraSeal), topical surgical sealant kit. Active substance: Человеческий фибриноген и человеческий тромбин / Human fibrinogen and human thrombin.
- What it is: a two-component fibrin sealant for stopping bleeding and sealing tissue.
- Presentation: a kit of two pre-filled syringes, ready to use.
- Status: a prescription item for use in the operating theatre.
- Research: reviews and controlled studies in surgical haemostasis, links below.
- Where to buy: APV Pharmacy (price and availability there).
Key facts
| Active substances | Human fibrinogen and human thrombin |
|---|---|
| Form | Kit of two pre-filled syringes |
| Strength | Fibrinogen about 60–100 mg/mL, thrombin about 500 IU/mL |
| Pack size | Topical application kit |
| Category | Prescription surgical product |
| Article (SKU) |
What a fibrin sealant is
A fibrin sealant is a topical product that helps to stop bleeding and to seal tissue during surgery. It consists of two components: human fibrinogen and human thrombin. Each component is held in its own syringe.
The composition reproduces the final step of blood coagulation. When the components are mixed, they form a white, elastic clot that clings to the wound surface and closes it mechanically.
The product is meant for use in the operating theatre. It is a prescription item applied by a surgeon, not by the patient at home.
How the clot forms
The work of thrombin
Thrombin is the enzyme that cuts fibrinogen molecules into separate fragments, fibrin monomers. These fragments join spontaneously into long threads that make up the network of the future clot.
Calcium ions and cross-links
In the presence of calcium ions the fibrin threads are further linked to one another, and the network becomes strong and stable. That is why the second component contains a solution with calcium ions.
What happens afterwards
The finished clot stays in place and provides both haemostasis and a fluid-tight seal. In time it is fully absorbed, as the body breaks fibrin down through its ordinary mechanisms.
Where fibrin sealants are used
The product is used where ordinary measures such as pressure, sutures or electrocautery are insufficient or awkward. These are capillary and parenchymal bleeding during open and laparoscopic procedures.
A second role is sealing: closing the line of a vascular anastomosis, reinforcing lung tissue, or treating the dura, where air or fluid must not leak through.
Fibrin glue is sometimes also used to fix surgical mesh or to bring wound edges together. In every case the surgeon decides during the operation.
What the research shows
A systematic review and meta-analysis in the European Journal of Vascular and Endovascular Surgery (2020) gathered data on fibrin and thrombin sealants in vascular and cardiac surgery and assessed their contribution to stopping bleeding.
A randomised multicentre trial in Annals of Vascular Surgery (2017) studied a ready-to-use fibrin sealant as an adjunct to conventional haemostasis in vascular procedures. A review in Drugs (2011) described the use of one such product.
A review in ACS Biomaterials Science & Engineering (2022) discusses the limitations of fibrin sealants and the situations where their advantage is not always clear. Overall the evidence supports them as an auxiliary method rather than a replacement for surgical technique.
Published research
Primary sources, verified against PubMed:
- Fibrin and Thrombin Sealants in Vascular and Cardiac Surgery: A Systematic Review and Meta-analysis., PubMed 32620348 (Eur J Vasc Endovasc Surg, 2020).
- Fibrin sealant (evicel [quixil/crosseal]): a review of its use as supportive treatment for haemostasis in surgery., PubMed 21942978 (Drugs, 2011).
- A Prospective, Randomized, Multicenter Clinical Trial on the Safety and Efficacy of a Ready-to-Use Fibrin Sealant as an Adjunct to Hemostasis during Vascular Surgery., PubMed 28647631 (Ann Vasc Surg, 2017).
- Fibrin Sealants: Challenges and Solutions., PubMed 35610572 (ACS Biomater Sci Eng, 2022).
Listed for reference. Publication of a study is not a claim about this particular product.
Precautions
- This is a prescription item for use in the operating theatre; it is not used by patients themselves.
- The product is applied topically only. Injection into blood vessels is not acceptable because of the risk of thromboembolic complications.
- Allergic reactions to the components are possible.
- Spraying under pressure onto an open wound is not used because of the risk of air embolism.
- Excess clot is removed to reduce the risk of adhesions.
- The components are prepared immediately before use and handled as directed in the manufacturer's information.
Frequently asked
Is this a medicine or a medical device?
It is a topical surgical product based on human fibrinogen and thrombin. It is applied by a surgeon.
Can it be used at home?
No. The product is intended for the operating theatre and is applied by healthcare professionals.
Why does this page not give a dosing schedule?
The manner and extent of application are decided by the surgeon during the operation. A reference page does not give instructions for use.
Where does the order ship from?
Shipping and customs handling are described on the APV Pharmacy delivery page.