Experience Improves Successful Use of Fibrin Sealant in Total Knee Arthroplasty: Implications for Surgical Education

Wang, Gwo-Jaw; Goldthwaite, Charles A.; Burks, Sandra G.; Spotnitz, William D.

doi:10.1615/jlongtermeffmedimplants.v13.i5.40

Cited by 23 publications

(20 citation statements)

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“…In a later work, in 2003, Wang et al [4] found that a later administration of fibrin sealant seemed to be more efficacious than an earlier application during the procedure.…”

Section: Discussionmentioning

confidence: 98%

“…In the literature, the results of five clinical studies of the use of fibrin glues to control bleeding in knee arthroplasty have been reported [4,6,14,[19][20][21].…”

Section: Discussionmentioning

confidence: 99%

“…The most satisfactory timing of the application of fibrin glues has also been assessed, comparing early and late intraoperative administration during total knee arthroplasty. A better outcome was observed with the administration at the end of the procedure [4]. In a recent work, three different application methods of fibrin sealant during thoracotomy were compared: a rubbing and spray method, in which fibrinogen was rubbed in and then fibrinogen and thrombin solutions were sprayed; a double-layer method in which fibrinogen was dripped and then thrombin applied; lastly, the application of a collagen fleece coated with fibrinogen and thrombin [5].…”

Section: Introductionmentioning

confidence: 99%

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Comparative efficacy of different doses of fibrin sealant to reduce bleeding after total knee arthroplasty

Notarnicola¹,

Moretti²,

Martucci³

et al. 2012

Blood Coagulation &Amp; Fibrinolysis

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In recent years, the application of fibrin sealant has been shown to be efficacious in the management of intraoperative and postoperative hemostasis. We designed a prospective randomized controlled clinical trial to assess the efficacy of two different dosages of fibrin sealant (5 and 10 ml) in patients undergoing total knee arthroplasty, as compared with the untreated control group. A total of 90 patients entered the study, randomly assigned to one of the three groups: treatment with 5 ml fibrin sealant (30 patients), with 10 ml fibrin sealant (30 patients) or no treatment (30 patients). A statistically significant difference in the mean reduction of hemoglobin concentrations was found on the first postoperative day in the treated groups as compared with the controls: 5 ml fibrin sealant (2.6 mg/dl) and 10 ml fibrin sealant (2.5 mg/dl) vs. controls (3.7 mg/dl) (P = 0.024). The mean number of blood transfusions was significantly lower in the treated groups: 5 ml (0.5) and 10 ml (0.3) of fibrin sealant vs. controls (1) (P = 0.0019). Functional recovery was also better in the treated groups: on the seventh day, the joint ROM (range of motion) was statistically superior in the 5 ml group (96.5°) and 10 ml group (98.8°) as compared with the controls (75.5°) (P < 0.0001). This study supports the efficacy of administering fibrin sealant in the perioperative management of bleeding after total knee arthroplasty and shows that a 5 ml dosage yields a comparable outcome to the 10 ml dosage previously reported in the literature.

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“…In a later work, in 2003, Wang et al [4] found that a later administration of fibrin sealant seemed to be more efficacious than an earlier application during the procedure.…”

Section: Discussionmentioning

confidence: 98%

“…In the literature, the results of five clinical studies of the use of fibrin glues to control bleeding in knee arthroplasty have been reported [4,6,14,[19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparative efficacy of different doses of fibrin sealant to reduce bleeding after total knee arthroplasty

Notarnicola¹,

Moretti²,

Martucci³

et al. 2012

Blood Coagulation &Amp; Fibrinolysis

View full text Add to dashboard Cite

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“…These efforts included work in a variety of surgical disciplines including breast [9, 13, 14, 16, 17, 32, 36], cardiovascular [11, 26, 27, 30, 33], gastrointestinal [10], head and neck [22, 35], hepatic [12, 20], neuro- [29], orthopedic [21, 37, 40, 41], pediatric [12], noncardiac thoracic [25, 30, 31, 33, 34], and vascular surgery [15, 18, 19, 23, 24, 38, 39]. This body of work emphasized the evolving versatility of fibrin sealant because it is capable of causing blood to clot, creating a sealing barrier, and gluing tissues together.…”

Section: Introductionmentioning

confidence: 99%

“…This body of work emphasized the evolving versatility of fibrin sealant because it is capable of causing blood to clot, creating a sealing barrier, and gluing tissues together. Also, these research efforts clarified that fibrin sealant often requires some hands on experience with the agent to maximize its effectiveness [40]. …”

Section: Introductionmentioning

confidence: 99%

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

2014

Self Cite

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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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Pharmacological interventions for the prevention of bleeding in people undergoing elective hip or knee surgery: a systematic review and network meta-analysis

Gibbs,

Champaneria,

Sandercock

et al. 2024

Cochrane Database of Systematic Reviews

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Background Hip and knee replacement surgery is a well‐established means of improving quality of life, but is associated with a significant risk of bleeding. One‐third of people are estimated to be anaemic before hip or knee replacement surgery; coupled with the blood lost during surgery, up to 90% of individuals are anaemic postoperatively. As a result, people undergoing orthopaedic surgery receive 3.9% of all packed red blood cell transfusions in the UK. Bleeding and the need for allogeneic blood transfusions has been shown to increase the risk of surgical site infection and mortality, and is associated with an increased duration of hospital stay and costs associated with surgery. Reducing blood loss during surgery may reduce the risk of allogeneic blood transfusion, reduce costs and improve outcomes following surgery. Several pharmacological interventions are available and currently employed as part of routine clinical care. Objectives To determine the relative efficacy of pharmacological interventions for preventing blood loss in elective primary or revision hip or knee replacement, and to identify optimal administration of interventions regarding timing, dose and route, using network meta‐analysis (NMA) methodology. Search methods We searched the following databases for randomised controlled trials (RCTs) and systematic reviews, from inception to 18 October 2022: CENTRAL (the Cochrane Library), MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO host ), Transfusion Evidence Library (Evidentia), ClinicalTrials.gov and WHO International Clinical Trials Registry Platform (ICTRP). Selection criteria We included RCTs of people undergoing elective hip or knee surgery only. We excluded non‐elective or emergency procedures, and studies published since 2010 that had not been prospectively registered (Cochrane Injuries policy). There were no restrictions on gender, ethnicity or age (adults only). We excluded studies that used standard of care as the comparator. Eligible interventions included: antifibrinolytics (tranexamic acid (TXA), aprotinin, epsilon‐aminocaproic acid (EACA)), desmopressin, factor VIIa and XIII, fibrinogen, fibrin sealants and non‐fibrin sealants. Data collection and analysis We performed the review according to standard Cochrane methodology. Two authors independently assessed trial eligibility and risk of bias, and extracted data. We assessed the certainty of the evidence using CINeMA. We presented direct (pairwise) results using RevMan Web and performed the NMA using BUGSnet. We were interested in the following primary outcomes: need for allogenic blood transfusion (up to 30 days) and all‐cause mortality (deaths occurring up to 30 days after the operation), and the following secondary outcomes: mean number of transfusion episodes per person (up to 30 days), re‐operation due to...

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Experience Improves Successful Use of Fibrin Sealant in Total Knee Arthroplasty: Implications for Surgical Education

Cited by 23 publications

References 0 publications

Comparative efficacy of different doses of fibrin sealant to reduce bleeding after total knee arthroplasty

Comparative efficacy of different doses of fibrin sealant to reduce bleeding after total knee arthroplasty

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

Pharmacological interventions for the prevention of bleeding in people undergoing elective hip or knee surgery: a systematic review and network meta-analysis

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