Fibrin Sealant Reduces Perioperative Blood Loss in Total Hip Replacement

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

doi:10.1615/jlongtermeffmedimplants.v13.i5.50

Cited by 51 publications

(34 citation statements)

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“…For example Surgicel® (Johnson & Johnson, Somerville, N.J., USA) consists of oxidized regenerated cellulose. Topical thrombin [79,80,81] and fibrin [81,82,83] sealants have evidence to show their efficacy in aiding hemostasis and as such can be thought of as adjuncts in an adhesion reduction strategy.…”

Section: Methods Of Adhesion Reductionmentioning

confidence: 99%

Abdominal Adhesion Prevention: Still a Sticky Subject

et al. 2010

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Background: Adhesion formation remains an almost inevitable consequence of abdominal procedures, potentially resulting in significant morbidity and mortality. There is an ongoing need to evaluate current understanding of adhesion formation and products aimed at prevention. Failure to keep up to date with adhesion treatment may subject clinicians to a greater medico-legal risk. Design: Review of published studies exploring the problem of peritoneal adhesion formation. This encompasses the underlying processes of adhesion formation combined with general approaches to reduce formation. An overview of products trialled to prevent formation in both the animal model and clinical setting describes products of scientific interest and commercial success. Results: Advances in surgical technique, such as laparoscopic surgery, can help minimize the probability of adhesion formation. Currently barrier products, whilst reducing adhesion formation, have not been shown to reduce the risk of readmission with complications related to adhesions. Hybrid products may improve upon this situation. Conclusions: No single approach has been wholly satisfactory in reducing adhesions. Research into the processes driving adhesion formation is providing exciting new targets for therapeutic agents. It would seem plausible that with many promising avenues of research a revolutionary agent to reduce the incidence of adhesional small bowel obstruction may result.

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Section: Methods Of Adhesion Reductionmentioning

confidence: 99%

Abdominal Adhesion Prevention: Still a Sticky Subject

et al. 2010

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“…For a period of 25 years, it was my own good fortune to have the opportunity to perform both laboratory [9–24] and clinical research on fibrin sealant [25–41]. 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].…”

Section: Introductionmentioning

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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“…A variety of blood management strategies have been used in the peri-operative period. Interventions including pharmacological agents,7) the anti-fibrinolytic agent tranexamic acid,8) fibrin sealants,9) and predonation of autologous blood have all demonstrated utility in orthopedic procedures 4,10). Perioperative blood salvage and cell salvage/re-transfusion have shown to be effective for reducing transfusion requirements,11) but results in TKA have been mixed 12,13)…”

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confidence: 99%

Saline-Coupled Bipolar Sealing in Simultaneous Bilateral Total Knee Arthroplasty

et al. 2014

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BackgroundThe efficacy of saline-coupled bipolar sealing devices in joint arthroplasty is uncertain, and the utility in simultaneous bilateral total knee arthroplasty (TKA) has not been reported.MethodsThis study compares the use of bipolar sealing and conventional electrocautery in 71 consecutive patients. The experimental and control groups were matched for age, sex, body mass index, American Society of Anesthesiologists (ASA) classification, and preoperative hemoglobin. Variables of interest included blood loss, transfusion requirements, and operative characteristics.ResultsIn comparison to patients treated with conventional electrocautery, those treated with the bipolar sealer were 35% less likely to require transfusion. The median number of transfusions per case was also significantly lower in the experimental group. Hemoglobin change, total blood loss, and length of stay were not significantly different between the groups. The experimental group had longer operative times.ConclusionsBipolar sealing shows promise as a blood loss reduction tool in simultaneous bilateral TKA. The marginal savings attributed to reduced transfusion rates with use of the bipolar sealer did not exceed the additional per-case expense of using the device. The decision to use the device with the goal of less blood loss must come with the additional expense associated with its use.

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Fibrin Sealant Reduces Perioperative Blood Loss in Total Hip Replacement

Cited by 51 publications

References 0 publications

Abdominal Adhesion Prevention: Still a Sticky Subject

Abdominal Adhesion Prevention: Still a Sticky Subject

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

Saline-Coupled Bipolar Sealing in Simultaneous Bilateral Total Knee Arthroplasty

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