Efficacy of Fibrin Sealant in Reducing Hemorrhage after a Loop Electrosurgical Excision Procedure

Kim, Kidong; Park, Sang-Il; Kim, Beob-Jong; Kim, Moon-Hong; Choi, Seok-Cheol; Ryu, Sang Baek; Lee, Eui-Don

doi:10.1159/000333266

Cited by 10 publications

(8 citation statements)

References 10 publications

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“…In addition, along with the decrease in postoperative vaginal bleeding, there was considerable improvement in the disability in everyday life (tables 2, 3). The results of the present study are consistent with those of earlier studies which reported that fibrin sealant has significant hemostatic effects in various surgical fields [12,13,14,15,16]. Furthermore, this study was the first prospective randomized study to demonstrate the potential hemostatic effects of fibrin sealant in LEEP for CIN 2 or 3.…”

Section: Discussionsupporting

confidence: 92%

A Pilot Study to Investigate the Efficacy of Fibrin Sealant (Tisseel®) in the Loop Electrosurgical Excision Procedure

Kim

Park

et al. 2015

Gynecol Obstet Invest

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Aims: The objective of the current study was to evaluate the efficacy and feasibility of fibrin sealant (Tisseel®) in the loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN 2 or 3). Methods: We designed a single-blind, prospective, randomized study in 40 consecutive women undergoing LEEP for CIN 2 or 3 at our institute. Two milliliters of fibrin sealant (Tisseel) was applied to the uterine cervix of 20 women immediately after LEEP surgery (treatment group). We evaluated abdominal pain, vaginal bleeding, vaginal discharge and impairment in daily living after 1 week using visual analogue scale questionnaires and compared the results with those of 20 women who did not receive fibrin sealant (control group). Results: Among 40 women who returned for a follow-up 1 week after LEEP, 25 women (62.5%) reported at least one moderate to severe postprocedural symptom. The mean duration of moderate to severe vaginal bleeding and impairment in daily living during postoperative week 1 for the treatment group and the control group was 0.3 ± 0.80 versus 1.7 ± 2.36 days (p = 0.015) and 0.9 ± 1.37 versus 3.00 ± 2.62 days (p = 0.060), respectively. Conclusion: Intraoperative application of fibrin sealant (Tisseel) in LEEP can decrease postoperative vaginal bleeding and impairment in daily living.

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Section: Discussionsupporting

confidence: 92%

A Pilot Study to Investigate the Efficacy of Fibrin Sealant (Tisseel®) in the Loop Electrosurgical Excision Procedure

Kim

Park

et al. 2015

Gynecol Obstet Invest

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“…Multiple additional papers address a variety of other topics and will be presented here in descending order of frequency (Table 5) for the use of fibrin sealant in the form of platelet-rich (PRP) or platelet-poor plasma (PPP) [203–213], hepatic surgery [214–222], neurosurgery [223–233], joint replacement orthopedic surgery [234–241], head and neck surgery [242–248], vascular surgery [61, 249–252], gastrointestinal surgery [253–258], gastroesophageal surgery [259–262], other orthopedic surgery [263–266], renal surgery [267–271], cardiac surgery [272–274], dental surgery [275–277], hemophilia [278–280], obstetrical and gynecological surgery [281–283], pancreatic surgery [284–286], transsphenoidal surgery [287–289], bariatric surgery [290, 291], drug delivery [292, 293], endoscopic polypectomy [294, 295], plastic surgery [83, 296], skull base reconstruction [297, 298], complications [299], trauma [300], and urology [301]. …”

Section: Less Frequently Published Clinical Applications Of Fibrinmentioning

confidence: 99%

“…The first paper described methods of treating immediate bleeding that included hemoclips and fibrin sealant [294] and the second retrospective study ( n = 344) suggested that fibrin sealant use based on multivariate analysis was associated with less delayed secondary hemorrhage following loop electrosurgical polyp excision ( P < 0.01) [295]. …”

Section: Less Frequently Published Clinical Applications Of Fibrinmentioning

confidence: 99%

Fibrin Sealant: The Only Approved Hemostat, Sealant, and Adhesive—a Laboratory and Clinical Perspective

2014

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Background. Fibrin sealant became the first modern era material approved as a hemostat in the United States in 1998. It is the only agent presently approved as a hemostat, sealant, and adhesive by the Food and Drug Administration (FDA). The product is now supplied as patches in addition to the original liquid formulations. Both laboratory and clinical uses of fibrin sealant continue to grow. The new literature on this material also continues to proliferate rapidly (approximately 200 papers/year). Methods. An overview of current fibrin sealant products and their approved uses and a comprehensive PubMed based review of the recent literature (February 2012, through March 2013) on the laboratory and clinical use of fibrin sealant are provided. Product information is organized into sections based on a classification system for commercially available materials. Publications are presented in sections based on both laboratory research and clinical topics are listed in order of decreasing frequency. Results. Fibrin sealant remains useful hemostat, sealant, and adhesive. New formulations and applications continue to be developed. Conclusions. This agent remains clinically important with the recent introduction of new commercially available products. Fibrin sealant has multiple new uses that should result in further improvements in patient care.

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“…Moreover, several hemostatic agents have been applied for reducing hemorrhage after LEEP; however, their effect on reducing hemorrhage remains controversial. Some studies demonstrated that Tissel (Baxter, Westlake Village, CA, USA) could reduce postoperative vaginal bleeding 20,21 . However, other reports showed that using hemostats such as Tachosil (Nycomen, Zurich, Switzerland) could not reduce postoperative vaginal bleeding 19,22 .…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a chitosan tampon in the loop electrosurgical excision procedure: A prospective randomized controlled study

Chong

Lee

Jeon

et al. 2020

Sci Rep

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It has been reported that chitosan has a hemostatic effect and an antibiotic activity. This study aimed to evaluate the efficacy and feasibility of using a chitosan tampon (Hemoblock-Tampon) in preventing hemorrhage and enhancing wound healing after the loop electrosurgical excision procedure (LEEP).This single-blind, prospective, randomized study included 62 consecutive patients who underwent LEEP for cervical intraepithelial neoplasia. A chitosan tampon (31 patients; treatment group), or a general tampon (31 patients; control group) was applied to the uterine cervix immediately after LEEP. One patient in the treatment group declined to participate in this study. Thus, 30 patients in the treatment group and 31 patients in the control group completed this study. For objective analysis of hemorrhage in the postoperative 2 weeks, the amounts of bleeding were checked daily with a pictorial blood assessment chart. We evaluated vaginal discharge, abdominal pain, and impairment in daily living during the postoperative 2 weeks using 5 visual analogue scale questionnaires.The bleeding count was significantly lower in the treatment group than in the control group (21.37 ± 16.86 vs. 40.52 ± 16.55, p = 0.0014). The sum of the scores of the 5 questionnaires was significantly lower in the treatment group than in the control group (6.53 ± 2.84 vs. 8.59 ± 2.88, p = 0.0079). The incidence of vaginal discharge was significantly lower in the treatment group than in the control group (20.0% vs. 48.4%, p = 0.0207). According to logistic regression, only the use of chitosan tampon reduced the risk of moderate to severe vaginal bleeding 2 weeks after surgery (Odd ratio, 0.213; 95% confidence interval, 0.06-0.76; p = 0.0172). Complete healing of the uterine cervix occurred in 86.7% of patients in the treatment group and in 61.3% of patients in the control group at 4 weeks after surgery (p = 0.0255).The use of chitosan tampons can reduce hemorrhage, vaginal discharge, abdominal pain, and impairment of daily living after LEEP. Moreover, chitosan tampon may help enhance wound healing.

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Efficacy of Fibrin Sealant in Reducing Hemorrhage after a Loop Electrosurgical Excision Procedure

Cited by 10 publications

References 10 publications

A Pilot Study to Investigate the Efficacy of Fibrin Sealant (Tisseel®) in the Loop Electrosurgical Excision Procedure

A Pilot Study to Investigate the Efficacy of Fibrin Sealant (Tisseel®) in the Loop Electrosurgical Excision Procedure

Fibrin Sealant: The Only Approved Hemostat, Sealant, and Adhesive—a Laboratory and Clinical Perspective

Efficacy of a chitosan tampon in the loop electrosurgical excision procedure: A prospective randomized controlled study

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