Fibrin Sealants in Facial Plastic Surgery: A National Database Analysis of Complication Risk.

Abstract

Objective: Fibrin sealants (FS) are gaining popularity in surgical practice. However, limited data exist for most facial plastic surgical (FPS) procedures.

Study design: Retrospective cohort.

Setting: The TriNetX Research Network.

Methods: The TriNetX national database was utilized to identify patients that underwent select FPS procedures. Cohorts included one group with FS recorded on the same day as the procedure, and another without. Demographics, comorbidities, and postoperative complications were investigated.

Results: A total of 550,777 patients underwent an FPS procedure, 600 patients with FS and 550,177 without. There was no difference in the rate of overall complications between groups (adjusted odds ratio [aOR] 0.92, [0.71-1.2], P = .54), with adjustment for age, race, ethnicity, marital status, nicotine use, and anticoagulation. However, higher rates of postoperative wound disruption (aOR 1.63, [1.14-2.33], P = .008) were seen in the FS group. Patients in the FS group had higher rates of nicotine use (12.7% vs 8.7%, P < .001) and anticoagulation (39.2% vs 27.7%, P < .001) overall. Subanalyses by procedure found increased rates of any postoperative complications for those with FS (aOR 1.51, [1.01-2.24], P = .044) in patients receiving regional flaps. There were no significant differences in postoperative complications between groups in patients receiving grafts, rhinoplasty, or rhytidectomy.

Conclusion: There were no differences in the rates of having any complications between groups overall. Patients receiving regional flaps and grafts experienced more complications. There were no significant differences between groups in patients receiving grafts, rhinoplasty, or rhytidectomy. Surgeons may consider utilizing FS for FPS procedures when appropriate.