title: Is the newest fibrin sealant an effective strategy to reduce blood loss after total knee arthroplasty? A randomized controlled study.
abstract: An RCT was conducted to ascertain whether, compared to control management, topical application of a novel fibrin sealant (Evicel, J&J) in patients undergoing primary TKA reduces peri-operative blood loss. Sixty-two patients were randomized to receive topical application of Evicel (N = 31) or not (N = 31). The mean total blood loss was 1.9L(± 0.7) in the control group and 1.8L(± 0.5) in the treatment group (P = 0.4). The transfusion rate was 32.3% in the control group and 25.8% in the treatment group (P = 0.5). The transfusion rate decreased linearly with increasing preoperative Hb levels in the treatment group (P = 0.005). The results of this study suggest that topical application of this novel fibrin sealant doesn't reduce perioperative blood loss and the need for allogeneic blood transfusion.
authors.affiliation: IRCCS, Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Randelli
authors.affiliation: IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: D'Anchise
authors.affiliation: IRCCS, Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Ragone
authors.affiliation: IRCCS, Policlinico San Donato, San Donato Milanese, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Serrao
authors.affiliation: IRCCS, Policlinico San Donato, San Donato Milanese, Milan, Italy; Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cabitza
authors.affiliation: IRCCS, Policlinico San Donato, San Donato Milanese, Milan, Italy; Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Randelli
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D006454:Hemoglobins; D006490:Hemostatics
keywords: blood loss; fibrin sealants; total knee arthroplasty