A randomized controlled trial on effects of different hemostatic sponges in posterior spinal fusion surgeries

Xu, Derong; Ren, Zhinan; Chen, Xin; Zhuang, Qianyu; Lin, Shih‐Yen; Li, Shugang

doi:10.1186/s12893-016-0197-3

Cited by 16 publications

(13 citation statements)

References 10 publications

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“…The use of collagen-based and gelatin-based products has led to a significant reduction in both intraoperative blood loss and postoperative transfusions. The effectiveness of these two types of products has been compared in a recent randomized controlled trial performed by Xu et al [ 40 ] on 92 patients who had undergone spinal fusion surgery. The authors concluded that collagen-based products demonstrated better hemostatic effect than gelatin-based products, with lower blood loss and postoperative drainage volume.…”

Section: Resultsmentioning

confidence: 99%

“…True sealants (“cross-linking”) can be divided into synthetic (PEG-polyethylene glycol-based and cyanoacrylate) [ 40 – 46 ] and semi-synthetic (glutaraldheide-albumin) [ 49 ]. In contrast to fibrin glue, cross-linking sealants polymerize through a non-enzymatic chemical reaction, which do not require the presence of blood or any components of the coagulation cascade.…”

Section: Resultsmentioning

confidence: 99%

“…Sealants are low viscosity liquids that polymerize forming a solid film that connects a-traumatically the tissue surfaces [ 40 – 53 ]. This property makes these agents effective both as sealants and as hemostats.…”

Section: Introductionmentioning

confidence: 99%

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A systematic review on the use of topical hemostats in trauma and emergency surgery

et al. 2018

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BackgroundA wide variety of hemostats are available as adjunctive measures to improve hemostasis during surgical procedures if residual bleeding persists despite correct application of conventional methods for hemorrhage control. Some are considered active agents, since they contain fibrinogen and thrombin and actively participate at the end of the coagulation cascade to form a fibrin clot, whereas others to be effective require an intact coagulation system. The aim of this study is to provide an evidence-based approach to correctly select the available agents to help physicians to use the most appropriate hemostat according to the clinical setting, surgical problem and patient’s coagulation status.MethodsThe literature from 2000 to 2016 was systematically screened according to PRISMA [Preferred Reporting Items for Systematic Reviews and Meta-Analyses] protocol. Sixty-six articles were reviewed by a panel of experts to assign grade of recommendation (GoR) and level of evidence (LoE) using the GRADE [Grading of Recommendations Assessment, Development and Evaluation] system, and a national meeting was held.ResultsFibrin adhesives, in liquid form (fibrin glues) or with stiff collagen fleece (fibrin patch) are effective in the presence of spontaneous or drug-induced coagulation disorders. Mechanical hemostats should be preferred in patients who have an intact coagulation system. Sealants are effective, irrespective of patient’s coagulation status, to improve control of residual oozing. Hemostatic dressings represent a valuable option in case of external hemorrhage at junctional sites or when tourniquets are impractical or ineffective.ConclusionsLocal hemostatic agents are dissimilar products with different indications. A knowledge of the properties of each single agent should be in the armamentarium of acute care surgeons in order to select the appropriate product in different clinical conditions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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A systematic review on the use of topical hemostats in trauma and emergency surgery

et al. 2018

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“…Previous research has shown that the hematocrit (Hct) of postoperative drainage may fluctuate over a wide range; therefore, the use of only the amount of drainage as the reference for postoperative blood loss is inaccurate. [ 10 ] In our study, we also examined the complete blood count (CBC) for every drainage sample to obtain Hct and hemoglobin (Hb) data, which were used to calculate the pure blood contained in the drainage.…”

Section: Methodsmentioning

confidence: 99%

Tranexamic acid reduce hidden blood loss in posterior lumbar interbody fusion (PLIF) surgery

Chen

et al. 2020

Medicine

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Background: Posterior lumbar interbody fusion (PLIF) surgery is associated with significant blood loss; however, few studies have focused on hidden blood loss (HBL) in PLIF or its regulatory factors. The purpose of this study was to explore the HBL in PLIF surgery as well as the influence of tranexamic acid (TXA) on blood loss in PLIF. Methods: We performed a randomized controlled trial (RCT) and recruited patients undergoing PLIF into the study from November 2013 to April 2017. All participants were assigned to one of 2 groups according to a simple equal probability randomization scheme. At the end of PLIF surgery, for patients in the TXA group, the surgical field was immersed in TXA (1 g in 100 mL of saline solution) for 5 min before stitching the wound. For the control group, the surgical field was immersed in the same volume of normal saline. Results: In our study, the drainage volume during the first 24 h and the total postoperative drainage volume were significantly lower in patients in the TXA group than in the control group ( P = .001). The hematocrit (Hct) of the drainage and calculation of blood contained in the drainage showed similar results. The mean length of hospital stay and rate of blood transfusion in the TXA group were less than those in the control group ( P < .05). HBL was responsible for 45.6% of the total blood loss in PLIF, and both of the indicators in the TXA group were much lower than those in the control group. Conclusions: PLIF is associated with massive perioperative HBL, but the application of topical TXA leads to less postoperative blood loss including less HBL, a lower blood product transfusion rate, and a shorter hospital stay for PLIF.

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“…Most of previous studies treated volume of drainage as postoperative blood loss; however, the volume of drainage is not equal to the postoperative blood loss according to the Gross formula. Because the component of drainage varied with time varying, so postoperative blood loss does not depend on the amount of fluid loss but the pure blood contained in drainage [ 11 , 12 ]. In our study, we also examined complete blood count (CBC) for every drainage sample to obtain data of HCT and hemoglobin (HGB), which were used to calculate the precise blood contained in drainage.…”

Section: Resultsmentioning

confidence: 99%

A randomized controlled trial on the effects of collagen sponge and topical tranexamic acid in posterior spinal fusion surgeries

Zhuang

Zheng

et al. 2017

J Orthop Surg Res

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BackgroundThis is a randomized controlled trial research to assess the hemostatic efficacy of gelatin sponge, collagen sponge, and topical use of tranexamic acid (TXA) on postoperative blood loss in posterior spinal fusion surgeries.MethodsWe recruited patients with spinal degenerative diseases into the study from November 2013 to October 2016. All the participants were assigned to 3 groups using a simple, equal-probability randomization scheme: group A is a control group utilizing gelatin sponge, while groups B and C are experimental groups, applying collagen hemostatic sponge and topical TXA respectively. Postoperative blood loss, rates of transfusion, and hospitalization were compared among the 3 groups.ResultsIn our study, the volume of drainage and blood content in drainage on the first postoperative day (POD 1) of patients in the experimental groups were significantly less than those in the control group, as well as rates of transfusion and postoperative hospitalization (P < 0.05). When compared with the control group, the volume of drainage decreased by 22.7% in group B and 56.2% in group C, while the blood content in drainage decreased by 28.8 and 75% respectively.ConclusionsIn this study, collagen and topical use of TXA have both proven to be effective and safe for patients undergoing posterior spinal fusion surgeries, while TXA has exhibited better efficacy. The total amount of perioperative blood loss reduced significantly without increasing incidence of related complications.Trial registrationA randomized controlled trial for effects of collagen sponge and topical tranexamic acid in posterior lumbar fusion surgeries. ChiCTR-IIR-17010785.

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A randomized controlled trial on effects of different hemostatic sponges in posterior spinal fusion surgeries

Cited by 16 publications

References 10 publications

A systematic review on the use of topical hemostats in trauma and emergency surgery

A systematic review on the use of topical hemostats in trauma and emergency surgery

Tranexamic acid reduce hidden blood loss in posterior lumbar interbody fusion (PLIF) surgery

A randomized controlled trial on the effects of collagen sponge and topical tranexamic acid in posterior spinal fusion surgeries

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