This is a well-written and well-designed prospective multicenter study evaluating the hemostatic effect of fibrin sealant on vascular anastomoses. A significantly better control of bleeding was shown when using fibrin sealant, compared to 4 minutes of manual pressure. A reasonable argument would then be: why only 4 minutes of manual compression and not, for example, 6 or 8? Is the cost of fibrin glue less than prolonging the operation by a few minutes? I believe this is a paper worth reading, but that it will not really change clinical practice.

– Constantine Vagianos