Use of fibrin sealant in neck contouring

Abstract

Background: The "suture suspension" platysmaplasty technique has been shown to be an effective and reliable procedure over the last decade. Objective: We investigated the effectiveness of fibrin sealant in reducing the recovery time after suture suspension platysmaplasty. Methods: After contouring the neck with our standard suture sling, hemostasis was assured. The instruments and gloves were wet with saline to prevent adherence to the sealant once it was applied. The 2 syringes were mounted on a Duploject applicator. The fibrin sealant was then sprayed simultaneously into the pockets in thin layers for 60 seconds, the time required for the liquid sealant to activate. Gentle manual pressure was applied over the neck skin, with the surgeon's fingers spread evenly over the whole neck, to prevent pooling of the fibrin sealant in any given area. This pressure was applied for 3 minutes, the time required for the tissue fibrin sealant to solidify. The incisions were closed in a standard fashion. Paper tape was used to cover the neck, and dressings were placed. Results: In 60 patients who underwent neck contouring with lipoplasty and suture suspension and lipoplasty with fibrin sealant between January and July 2001, the time necessary to return to activities of daily living was reduced from 7 to 10 days to 2 to 3 days by the use of fibrin sealant. No complications were reported. Conclusions: The use of fibrin tissue sealant has markedly improved the postoperative course of patients who underwent the neck suture suspension procedure by both eliminating most potential complications and decreasing recovery time.