title: Hemostatic techniques following multilevel posterior lumbar spine surgery: a randomized control trial.
abstract: METHODS
  This was a prospective, randomized controlled clinical study.
  
  
  OBJECTIVE
  To determine the efficacy of absorbable gelatin sponge in reducing blood loss, as well as shortening the length of hospital stay in patients undergoing multilevel posterior lumbar spinal surgery.
  
  
  BACKGROUND
  Absorbable gelatin sponge is reported to decrease postoperative drain output and the length of hospital stay after multilevel posterior cervical spine surgery. However, there is a dearth of literature on prospective study of the efficacy of absorbable gelatin sponge in reducing postoperative blood loss, as well as shortening the length of hospital stay in patients undergoing multilevel posterior lumbar spinal surgery.
  
  
  METHODS
  A total of 82 consecutive patients who underwent multilevel posterior lumbar fusion or posterior lumbar interbody fusion between June 2011 and June 2012 were prospectively randomized into one of the 2 groups according to whether absorbable gelatin sponge for postoperative blood management was used or not. Demographic distribution, total drain output, blood transfusion rate, the length of stay, the number of readmissions, and postoperative complications were analyzed.
  
  
  RESULTS
  Total drain output averaged 173 mL in the study group and 392 mL in the control group (P=0.000). Perioperative allogeneic blood transfusion rate were lower in the Gelfoam group (34.1% vs. 58.5%, P=0.046); moreover, length of stay in patients with the use of absorbable gelatin sponge (12.58 d) was significantly shorter (P=0.009) than the patients in the control group (14.46 d). No patient developed adverse reactions attributable to the absorbable gelatin sponge.
  
  
  CONCLUSIONS
  Application of absorbable gelatin sponge at the end of multilevel posterior lumbar fusion can significantly decrease postoperative drain output and length of hospital stay.
authors: Spinal Unit of Orthopedic Department of Zhejiang Provincial People's Hospital, Zhejiang, P. R. China.
authors: Jian
authors: J
authors: Wu
authors: Yongming
authors: Y
authors: Jin
authors: Jun
authors: J
authors: Zhang
authors: Haiyu
authors: H
authors: Shao
authors: Di
authors: D
authors: Yang
authors: Jinping
authors: J
authors: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion / Q000706:statistics & numerical data; D004322:Drainage; D005260:Female; D005780:Gelatin; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006489:Hemostatic Techniques; D006801:Humans; D007902:Length of Stay; D008161:Lumbosacral Region / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D013123:Spinal Fusion; D013131:Spine / Q000601:surgery*; D015503:Surgical Sponges
chemical_list: D006454:Hemoglobins; D005780:Gelatin