Fibrin glue consists of two main components: fibrinogen and thrombin.^1,2 These are loaded into two syringes with tips forming a common port. When injected the two components meet in equal volumes at the point of delivery. The thrombin converts the fibrinogen to fibrin by enzymatic action at a rate determined by the concentration of thrombin. The more concentrated thrombin solution produces a fibrin clot in about 10 seconds, and the more dilute thrombin solution forms the clot about 60 seconds after the glue is applied to the surgical field. Both the extrinsic and the intrinsic mechanisms of blood coagulation are bypassed, but the physiological final common pathway of coagulation is faithfully replicated. Factor XIII (present in the fibrinogen component of the glue) cross links and stabilises the clot's fibrin monomers. Some preparations of fibrin glue contain aprotinin to delay the fibrinolytic action of plasmin.3

Modern surgical techniques are efficient at securing haemostasis, but …