2017-18 HSC Section 4 Green Book

Aesthetic Surgery Journal 35(3)

and studying one ’ s own practice could be enlightening to individual readers. Careful attention was taken to avoid trials on platelet- rich plasma and to only include randomized, controlled trials on fi brin glue. Platelet-rich plasma is a concentration of platelets and fi brinogen formed by centrifuging autolo- gous blood. Compared to fi brin glue, platelet-rich plasma has a much higher concentration of platelets and a lower concentration of fi brinogen. It accelerates clot formation, much like fi brin glue, but its main usage is for the angio- genic growth factors released by the platelets rather than as a hemostatic adjunct. 18 The senior authors of this meta- analysis use autologous, platelet-rich plasma as a spray to facilitate quicker healing and decreased in fl ammation, not for the purposes of hemostasis. Over a 15-year period, this appears to have led to reduced swelling, bruising, and re- covery time. One might theorize that tissue adherence may inhibit or reduce the immediate tissue response to injury. However, this is anecdotal, opinion-based evidence, and must be investigated further. CONCLUSION The fi ndings of this meta-analysis reveal that the use of fi brin glue in facelifts reduces the risk of hematoma when compared to standard treatment. Hematoma is the most frequent cause of morbidity and patient dissatisfaction with facelifts. Like many prospective studies in aesthetic surgery, the trials on fi brin glue in rhytidectomies have generally had small sample sizes, which is why this meta-analysis was important. The only previous meta-analysis lacked adequately large studies to draw statistically signi fi cant conclusions. This meta-analysis con fi rms the promising usage of fi brin glue in reducing com- plications, particularly those related to hematoma. Disclosures The authors declare no potential con fl icts of interest with respect to the research, authorship, and publication of this article. Funding The authors received no fi nancial support for the research, authorship, and publication of this article. REFERENCES 1. Jones BM, Grover R. Avoiding hematoma in cervicofacial rhytidectomy: a personal 8-year quest; reviewing 910 patients. Plast Reconstr Surg . 2004;113(1):381-390. 2. Nowotny R, Chalupka A, Nowotny C, et al. Mechanical properties of fi brinogen adhesive material. In: Winter GD,

Gibbons DFPlenk H Jr, eds. Biomaterials . New York, NY: John Wiley & Sons, 1982, p. 677. 3. Marchac D, Greensmith AL. Early postoperative ef fi cacy of fi brin glue in face lifts: A prospective randomized trial. Plast Reconstr Surg . 2005;115(3):911-916. 4. Oliver DW, Hamilton SA, Figle AA, et al. A prospective, randomized, double-blind trial of the use of fi brin sealant for face lifts. Plast Reconstr Surg . 2001;108(7):2101-2105. 5. Fezza JP, Cartwright M, Mack W, Flaharty P. The use of aerosolized fi brin glue in face-lift surgery. Plast Reconstr Surg . 2002;110(2):658-664. 6. Kamer FM, Nguyen DB. Experience with fi brin glue in rhytidectomy. Plast Reconstr Surg . 2007;120(4):1045- 1051. 7. Lee S, Pham AM, Pryor SG, Tollefson T, Sykes JM. Ef fi cacy of crosseal fi brin sealant (human) in rhytidec- tomy. Arch Facial Plast Surg . 2009;11(1):29-33. 8. Hester TR, Gerut ZE, Shire JR, et al. Exploratory, random- ized, controlled, phase 2 study to evaluate the safety and ef fi cacy of adjuvant fi brin sealant VH S/D 4 S-apr (ARTISS) in patients undergoing rhytidectomy. Aesthet Surg J . 2013;33(3):323-333. 9. Hester TR, Shire JR, Nguyen DB, et al. Randomized, con- trolled, phase 3 study to evaluate the safety and ef fi cacy of fi brin sealant VH S/D 4 s-apr (artiss) to improve tissue adherence in subjects undergoing rhytidectomy. Aesthet Surg J . 2013;33(4):487-496. 10. Por Y, Shi L, Samuel M, Song C, Yeow VK. Use of tissue sealants in face-lifts: A metaanalysis. Aesthet Plast Surg . 2009;33(3):336-339. 11. DerSimonian R, Laird N. Meta-analysis in clinical trails. Control Clin Trials . 1986;7(3):177-188. 12. Morikawa T. Tissue sealing. Am J Surg . 2001;182: 29S-35S. 13. Mommaerts MY, Beirne JC, Jacobs WI, et al. Use of fi brin glue in lower blepharoplasties. J Craniomaxillofac Surg . 1996;24:78-82. 14. Marchac D, Ascherman J, Arnaud E. Fibrin glue fi xation in forehead endoscopy: Evaluation of our experience with 206 cases. Plast Reconstr Surg . 1997;100:704-712. 15. Zoumalan R, Rizk SS. Hematoma rates in drainless deep- plane face-lift surgery with and without the use of fi brin glue. Arch Facial Plast Surg . 2008;10(2):103-107. 16. Marchac D, Sandor G. Face lifts and sprayed fi brin glue: an outcome analysis of 200 patients. Br J Plast Surg . 1994;47(5):306-309. 17. Jones B, Grover R, Hamilton S. The ef fi cacy of surgical drainage in cervicofacial rhytidectomy: A prospective, randomized controlled trial. Plast Reconstr Surg . 2007; 120:263-270. 18. Findikcioglu F, Findikcioglu K, Yavuzer R, et al. Effect of intraoperative platelet-rich plasma and fi brin glue appli- cation on skin fl ap survival. J Craniofac Surg . 2012;23 (5):1513-1517.

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