Some preparations of fibrin glue contain Aprotinin to delay the fibrinolytic action of plasmin. Fibrin glue is a blood product obtained from either commercial sources or regional blood transfusion centers. The products are produced from pools of plasma, and the final products usually contain high yields of fibrinogen and, as a result, produce firm coagulum. The thrombin used in preparations of fibrin glue is of bovine origin. However human thrombin is also available.

In our institute we have used fibrin glue in various surgeries like tympanoplasty, CSF leak closure, ossiculoplasty. 144 patients underwent tympanoplasty over a period of 1 year and fibrin glue was used in 54 patients. We found that the graft uptake was good in all the patients and there was no incidence of reperforation in any of the patients. In 5 patients who under went surgery for CSF rhinorrhoea the leak closure was reinforced with fibrin glue and there was no reports of recurrence of the leaks, we have used fibrin glue in 7 cases of ossiculoplasty and found that the hearing improvement was better as compared to the patients without fibrin glue. So far we have not come across any adverse reactions to the fibrin glue. Though the cost of the fibrin glue is more we manage to have 2-3 cases in the same day so that the cost is divided. One disadvantage is if there is mucosalization of the TM external side, once grafts are placed the mucosa tends to grow fast and can lead to Myringitis like situation. This has to be controlled by excising all areas of mucosalised TM prior to grafting. This problem is more in fibrin as the glue has cell growth promoting effect.