Reducing blood loss at myomectomy with use of a gelatin-thrombin matrix hemostatic sealant.
OBJECTIVE
To evaluate the hemostatic efficacy and handling of gelatin-thrombin matrix in abdominal myomectomy.


METHODS
Prospective and randomized trial.


METHODS
University teaching hospital.


METHODS
Women (n = 50) with uterine fibroids with a uterine size equivalent to > or =16 weeks gestation.


METHODS
Gelatin-thrombin matrix (FloSeal Matrix; Baxter Healthcare Corp., Fremont, CA) was delivered to the site of the uterine bleeding during myomectomy.


METHODS
Patient age, parity, number of myomas, operative time, blood loss, transfusion, intraoperative and postoperative complications, and length of hospitalization were evaluated.


RESULTS
The average blood loss during surgery was 80 +/- 25.5 mL for the FloSeal group and 625 +/- 120.5 mL for the control group. Intraoperative blood transfusion was necessary in five patients from the control group. Postoperative blood loss was 25 +/- 5 mL for the FloSeal group and 250 +/- 75 mL for the control group. Length of the postoperative hospital stay was 2.5 +/- 1.2 days for FloSeal group and 4.5 +/- 1.3 for the control group. No major immediate or delayed complications were observed in either group.


CONCLUSIONS
Reductions in hemorrhage in FloSeal-treated women undergoing a myomectomy are encouraging, and provide evidence for the ability of gelatin-thrombin matrix to reduce blood loss when applied immediately and directly to bleeding uterine tissue.
Departamento de Obstetricia y Ginecologia, Hospital Clinico Universitario de Valencia, Valencia, Spain. raga_fra@gva.es
Francisco
F
Raga
Magda
M
Sanz-Cortes
Francisco
F
Bonilla
Eva María
EM
Casañ
Fernando
F
Bonilla-Musoles
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D005780:Gelatin; D006488:Hemostasis, Surgical / Q000009:adverse effects; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D009214:Myoma / Q000601:surgery*; D018579:Patient Selection; D011446:Prospective Studies; D013917:Thrombin; D014594:Uterine Neoplasms / Q000601:surgery*; D055815:Young Adult
D006490:Hemostatics; D005780:Gelatin; D013917:Thrombin