title: Fibrin tissue adhesive reduces postoperative blood loss in total knee arthroplasty.
abstract: BACKGROUND
  Blood transfusion is often required in total knee replacement; various methods of blood preservation have been studied. The best solution is to reduce the loss of blood during and after surgery.
  
  
  METHODS
  We designed this study to evaluate the hemostatic efficacy and safety of fibrin tissue adhesive (Quixil) in patients receiving total knee arthroplasty [low contact stress (LCS, DePuy, Warsaw, IN, US) cementless total knee replacement (TKR)] with a prospective, randomized, standard treatment controlled study. Thirty-five patients were randomized to receive treatment with fibrin tissue adhesive (treatment group), and 35 were randomized to be managed with postoperative blood recovery and reinfusion (control group). Blood loss in suction drain, decrease in hemoglobin values, and transfusions were recorded.
  
  
  RESULTS
  A significant reduction in apparent total blood loss was detected in the treatment group compared with the control group. There was also a lower decrease in hemoglobin level, although this difference was not significant. When fibrin tissue adhesive was administered, the need for transfusions was lower. No major adverse events were recorded in our series.
  
  
  CONCLUSIONS
  Fibrin tissue adhesive reduced blood loss in TKR and seemed to significantly reduce the need for blood transfusion. Fibrin tissue adhesive can be an appropriate solution to enhance hemostasis and vessel sealing at the operative site in TKR, in order to reduce blood loss after surgery and the risk of complications.
authors.affiliation: Orthopedics and Traumatology Department, Ospedale Civile di Saluzzo, Via Spielberg 58, 12037, Saluzzo, CN, Italy. luigisabatini.ort@gmail.com
authors.forename: Luigi
authors.initials: L
authors.lastname: Sabatini
authors.forename: Andrea
authors.initials: A
authors.lastname: Trecci
authors.forename: Daniele
authors.initials: D
authors.lastname: Imarisio
authors.forename: Marco Davide
authors.initials: MD
authors.lastname: Uslenghi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bianco
authors.forename: Roberto
authors.initials: R
authors.lastname: Scagnelli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology*; D005500:Follow-Up Studies; D006490:Hemostatics / Q000494:pharmacology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D006490:Hemostatics