Comparison of autogenous bone graft donor site haemostatic agents used in spinal surgery.
OBJECTIVE
The aim of our study was to investigate the effects of haemostatic agents used at the autograft donor sites in spinal fusion.


METHODS
The study included 66 patients (26 men, 40 women; mean age: 42.9 years) who underwent spinal fusion surgery between March 1999 and October 2002. Patients were randomly assigned to 4 different groups according to the haemostatic agents used during surgery. In Group 1, bone wax was used on the graft donor site. In Group 2, spongostan was used. In Group 3, spongostan was applied to the donor site and removed after 10 minutes. Group 4 was the control group and no haemostatic agent was applied. Age, sex, diagnosis and incision shape were not taken into consideration during the selection of patient groups. Closed suction drainage systems were used for the evaluation of drainage amount. The drainage system was removed after 48 hours in patients with a daily drainage of less than 30 cc.


RESULTS
In Group 1, there was significantly less drainage than the other groups. Group 2 and Group 3 had less drainage than the control group. When a separate incision was used for graft harvesting, keeping the spongostan at the application site (Group 2) was more effective than its removal (Group 3).


CONCLUSIONS
The application of bone wax and spongostan to bleeding cancellous bone surfaces at the donor site is a safe and effective method to reduce bleeding and hematoma. Bone wax is more effective than spongostan for haemostasis.
Department of Orthopaedics and Traumatology, Faculty of Medicine, Trakya University, Edirne, Turkey. cemcopuroglu@trakya.edu.tr
Cem
C
Copuroğlu
Selçuk
S
Ercan
Mert
M
Ozcan
Mert
M
Ciftdemir
F Nesrin
FN
Turan
Erol
E
Yalniz
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005339:Fibrin Foam / Q000627:therapeutic use; D005500:Follow-Up Studies; D006406:Hematoma / Q000517:prevention & control; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007085:Ilium / Q000601:surgery / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D010168:Palmitates / Q000627:therapeutic use; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000175:diagnosis / Q000601:surgery; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D060053:Transplant Donor Site; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014885:Waxes / Q000627:therapeutic use; D055815:Young Adult
D005339:Fibrin Foam; D006490:Hemostatics; D010168:Palmitates; D014885:Waxes; C055480:bone wax