Is the Newest Fibrin Sealant an Effective Strategy to Reduce Blood Loss After Total Knee Arthroplasty? A Randomized Controlled Study

• Published in: The Journal of arthroplasty Vol. 29; no. 8; pp. 1516 - 1520
• Main Authors: Randelli, Filippo, MD, D’Anchise, Roberto, MD, Ragone, Vincenza, MEng, Serrao, Luca, MD, Cabitza, Paolo, MD, Randelli, Pietro, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2014
• Subjects: Aged; Arthroplasty, Replacement, Knee - adverse effects; blood loss; Blood Loss, Surgical - prevention & control; Blood Transfusion; Female; fibrin sealants; Fibrin Tissue Adhesive - therapeutic use; Hemoglobins - metabolism; Hemostatics - therapeutic use; Humans; Length of Stay; Logistic Models; Male; Middle Aged; Orthopedics; Postoperative Hemorrhage - prevention & control; total knee arthroplasty; Treatment Outcome; total knee arthroplasty; fibrin sealants; blood loss
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2014.02.024

Abstract An RCT was conducted to ascertain whether, compared to control management, topical application of a novel fibrin sealant (Evicel, J&J) in patients undergoing primary TKA reduces peri-operative blood loss. Sixty-two patients were randomized to receive topical application of Evicel (N = 31) or not (N = 31). The mean total blood loss was 1.9 L(± 0.7) in the control group and 1.8 L(± 0.5) in the treatment group ( P = 0.4). The transfusion rate was 32.3% in the control group and 25.8% in the treatment group ( P = 0.5). The transfusion rate decreased linearly with increasing preoperative Hb levels in the treatment group ( P = 0.005). The results of this study suggest that topical application of this novel fibrin sealant doesn't reduce perioperative blood loss and the need for allogeneic blood transfusion.