title: A prospective study of the efficacy of clinical application of a new carrier-bound fibrin sealant after liver resection.
abstract: OBJECTIVE
  To examine the effectiveness of fibrin sealants as supportive treatment to improve hemostasis and decrease the incidence of bile leakage and intra-abdominal collections.
  
  
  METHODS
  Prospective, controlled, quasiexperimental study.
  
  
  METHODS
  Tertiary referral center, University Hospital Reina Sofía.
  
  
  METHODS
  A total of 115 patients (58 in the control group and 57 in the collagen sponge group) scheduled for conventional hepatectomies.
  
  
  METHODS
  Patients were distributed into groups for major and minor hepatectomies with or without application of a carrier-bound collagen sponge on the raw surface of the liver.
  
  
  METHODS
  The main outcome measures were postoperative mortality, incidence and severity of postoperative surgical complications, and length of hospital stay. The secondary outcome measures were postoperative drainage output volume, transfusion requirements, and changes in biochemical parameters (hemoglobin, bilirubin, alanine aminotransferase, and platelet levels).
  
  
  RESULTS
  The fibrin sealant after major liver resection was effective for decreasing drainage volume (mean [SD] volume, 1124.7 [842.8] mL in the control group and 691.2 [499.5] mL in the collagen sponge group; P = .007) with a higher volume of output by drain each postoperative day in the control patients (P = .003); postoperative blood transfusion requirements (18.9% vs 7.0%, respectively; P = .04); moderate to severe postoperative complications (21% vs 8%, respectively; P = .03); and mean (SD) hospital stay (12.6 [6.7] vs 9.6 [5.1] days, respectively; P = .03).
  
  
  CONCLUSIONS
  The use of a new carrier-bound collagen sponge after major liver resection may be recommended because of its clinical and cost-savings effectiveness.
authors.affiliation: Unit of Hepatobiliary Surgery and Liver Transplantation, Department of General Surgery, University Hospital Reina Sofía, Córdoba, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Briceño
authors.forename: Alvaro
authors.initials: A
authors.lastname: Naranjo
authors.forename: Ruben
authors.initials: R
authors.lastname: Ciria
authors.forename: Rafael
authors.initials: R
authors.lastname: Díaz-Nieto
authors.forename: Juan-Manuel
authors.initials: JM
authors.lastname: Sánchez-Hidalgo
authors.forename: Antonio
authors.initials: A
authors.lastname: Luque
authors.forename: Sebastián
authors.initials: S
authors.lastname: Rufián
authors.forename: Pedro
authors.initials: P
authors.lastname: López-Cillero
mesh_terms: D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D004322:Drainage; D004337:Drug Carriers; D004338:Drug Combinations; D005260:Female; D005340:Fibrinogen / Q000627:therapeutic use*; D006488:Hemostasis, Surgical / Q000379:methods*; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D007902:Length of Stay; D008107:Liver Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011446:Prospective Studies; D013917:Thrombin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D004337:Drug Carriers; D004338:Drug Combinations; C518955:TachoSil; D005340:Fibrinogen; D013917:Thrombin