Effect of fibrin vs cellulose based haemostatic agents with traditional haemostatic procedures in thyroid surgery

Karanikolić, Aleksandar; Miodagl, Djordjevic; Djordjevic, N.; Golubović, Ilija

doi:10.12669/pjms.336.13692

Cited by 7 publications

(4 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, physical agents didn't show advantages over conventional surgical techniques on time to drain removal, length of hospital stay and seroma formation 3,4,21 . We found no studies proving physical agents being more efficient than biologically active ones 1,3,4,21 . Only Amit et al found that the use of an oxidized cellulose hemostatic agent resulted in longer time to drain removal, and consequently in length of hospital stay, if compared with conventional procedures, suggesting that postoperative hemorrhage can best be prevented by proper intraoperative hemostasis 25 .…”

mentioning

confidence: 78%

“…The use of hemostatic agents in thyroid surgery has been widely reported in the literature, but their effectiveness in preventing postoperative bleeding remains controversial 17 . Considering biologically active agents only, some studies demonstrated an advantage over standard treatment in terms of mean operation time, reduction of 24-h drain output, time to drain removal, incidence of post-operative seroma and length of hospital stay 1,3,4,[18][19][20][21][22] . Others found a lack of advantages on reducing perioperative bleeding, time to drain removal and length of hospital stay 23,24 , causing only additional costs 24 .…”

mentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of hemostatic agents in thyroid surgery for the prevention of postoperative bleeding

Scaroni¹,

Holzen

Nebiker

2020

Sci Rep

View full text Add to dashboard Cite

Postoperative bleeding remains one of the most frequent, but rarely life-threatening complications in thyroid surgery. Although arterial bleeding is the main cause of postoperative hemorrhage, most often no actively bleeding vessel can be found during revision. Therefore, the coagulation technique for larger vessels may play a minor role, and hemostatic agents could be of higher importance. In this descriptive, retrospective study, data of 279 patients with thyroid surgery (total of 414 thyroid lobectomies) were collected. We reviewed the electronic medical record by analyzing the histological, operative, laboratory and discharge reports in regards to postoperative bleeding. Of the 414 operated thyroid lobes, 2.4% (n = 10) bled. 1.4% (n = 6) needed reoperation while the other 1.0% (n = 4) could be treated conservatively. Hemostatic patches were applied 286 (69.1%) times. Of the 128 (30.9%) patch-free operated sides, 4.7% (n = 6) suffered postoperative bleeding. Tachosil ® alone was used 211 (51.0%) times and bleeding occurred in 1.4% (n = 3). Without statistical significance (p = 0.08) the use of Tachosil ® seems to help preventing postoperative bleeding. The combination with other patches doesn't appear to be more efficient. Due to its endocrine function, the thyroid gland is a well perfused organ. For this reason, a good hemostasis during surgical procedures is of utmost importance. Postoperative bleeding remains one of the most frequent complications, and can cause airway compression and respiratory distress in severe cases. Moreover, intraoperative bleeding can obscure important structures like the parathyroid glands and the recurrent laryngeal nerve, complicating surgical dissection and increasing morbidity Aleksandar, et al. 1-3. The frequency of postoperative cervical hematoma (PCH) in thyroid surgery requiring reoperation ranges from 0 to 9.1% 4 , and it is the most common reason for return to the operating room 5. Many factors influence perioperative hemostasis. In the literature, several preoperative patient's risk factors are described, such as Grave's disease 6-9 , benign pathology 6,8,9 , the use of anticoagulation or antiplatelet medication while doing surgery 6,10 , an increased size of the pathology specimen 6 , an emergent admission 8 , presence of 2 or more comorbidities 8 , previous thyroid surgery 9 , age 65 years and older 7,11 , African-American race 7 and history of alcohol abuse 7. A BMI greater than 30 kg/m 2 11,12 and male sex 7,9,11 are also independent risk factors associated with PCH. Furthermore, postoperative hypertension increases the risk of postoperative bleeding 9,13. In the past century, the only instruments at a surgeon's disposal to obliterate vessels were needle and thread in order to create a ligation. Nowadays, the industry provides a variety of devices to seal and cut vessels, such as metal clips, bipolar coagulation forceps (e.g. BiClamp ®) and ultrasound scissors. The type of sealing technique doesn't seem to affect the risk of postoperative bleeding. Alesina et al. and...

show abstract

mentioning

confidence: 78%

mentioning

confidence: 99%

Effectiveness of hemostatic agents in thyroid surgery for the prevention of postoperative bleeding

Scaroni¹,

Holzen

Nebiker

2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…The study suggested that fibrin-based hemostats should be used as a first-line hemostatic agent in thyroidectomy in combination with conventional surgical means of hemostasis [41].…”

Section: Intraoperative Considerationsmentioning

confidence: 99%

Predictors and Preventive Strategies of Bleeding After Thyroid Surgery

Ezzy,

Alameer

2023

Cureus

View full text Add to dashboard Cite

Postoperative compressive neck hematoma occurs in approximately 0.1% to 1.7% of cases, most occurring within the first six hours after surgery. Thyroid pathology, patient predisposition, and surgical technique are major risk factors for postoperative hematoma. This narrative review describes current perspectives on predicting and preventing bleeding following thyroid surgery.Predictors of bleeding after thyroid surgery include patient-related factors such as male sex and age, surgery-related factors like total thyroidectomy and operations for thyroid malignancy, and surgeon-related factors. Hemostasis is the primary focus after preserving critical structures in thyroid surgery.The clamp-and-tie technique has been the standard method for dividing the thyroid gland's main vascular pedicles for many years. Bipolar electrocautery has been used for vessels of small size. However, advanced bipolar and ultrasound energy and hybrid devices are now available options that may reduce operative time without increasing costs or complications.In cases where small bleeders close to critical structures are present and the clamp-and-tie technique is not feasible, hemostatic agents are commonly used. Drains do not appear to provide any significant benefits in preventing the sequelae of bleeding after thyroid surgery.

show abstract

“…Studies for the biologically active agents demonstrate an advantage over standard treatment in the mean operation time, reduction of 24-h DV, time to drain removal, incidence of post-operative seroma and length of hospital stay [ 8 , 11 – 16 ]. However, not all studies confirm these findings [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of four different hemostatic agents in thyroid surgery in reducing the amount of post-operative fluid collection

von Ahnen,

Militz-Müller

et al. 2023

BMC Surg

View full text Add to dashboard Cite

Purposes Postoperative bleeding remains a life-threatening complication in thyroid surgery. The aim was to assess the efficacy of four different hemostatic agents, Collagen-Fibrinogen-Thrombin Patch (CFTP) in two sizes (3 × 2.5 cm and 9.5 × 4.8 cm), polysaccharide particles (1 g) and Cellulose Gauze (2.5 × 5 cm) on postoperative drainage volume (DV) compared to a control group. Methods We included from October 2007 until Mai 2011, 150 patients (30 per group) for this monocentric, retrospective case-controlled study. Patients were scheduled for a hemithyroidectomy or thyroidectomy. The primary endpoint was the postoperative DV within the first 24 h, secondary the incidence of adverse events. Results There were no difference in demographic parameters. The mean DV (± SD) was 51.15 (± 36.86) ml in the control, 50.65 (± 42.79) ml in small (3 × 2.5 cm), 25.38 (± 23.99) ml in large CFTP (9.5 × 4.8 cm), 53.11 (± 39.48) ml in the polysaccharide particles and 48.94 (± 30.59) ml in the cellulose gauze group. DV was significantly reduced with the large CFTP (p < 0.05) compared to all other groups. There were no adverse events. Conclusions We were able to demonstrate a significant reduction in the DV for the large CFTP group compared to the other collectives. Although this as being associated with not inconsiderable costs and we would only recommend its use for high-risk patients only.

show abstract

Effect of fibrin vs cellulose based haemostatic agents with traditional haemostatic procedures in thyroid surgery

Cited by 7 publications

References 23 publications

Effectiveness of hemostatic agents in thyroid surgery for the prevention of postoperative bleeding

Effectiveness of hemostatic agents in thyroid surgery for the prevention of postoperative bleeding

Predictors and Preventive Strategies of Bleeding After Thyroid Surgery

Efficacy of four different hemostatic agents in thyroid surgery in reducing the amount of post-operative fluid collection

Contact Info

Product

Resources

About