title: A Gelatin-Thrombin Matrix Topical Hemostatic Agent (Floseal) in Combination With Harmonic Scalpel Is Effective in Patients Undergoing Total Thyroidectomy: A Prospective, Multicenter, Single-Blind, Randomized Controlled Trial.
abstract: BACKGROUND
  Hemostasis during thyroidectomy is essential; however, the safest, most efficient, and most cost-effective way to achieve this is unclear. This randomized, multicenter, single-blind, prospective study evaluated the efficacy and safety of using different hemostatic approaches in patients undergoing total thyroidectomy.
  
  
  METHODS
  Patients aged ≥18 to 70 years were randomized to Floseal + a harmonic scalpel (HS), Floseal alone, HS alone, or standard total thyroidectomy. Primary endpoint was 24-hour drain output. Secondary endpoints included surgery duration and complications.
  
  
  RESULTS
  Two hundred and six patients were randomized to Floseal + HS (n = 52), Floseal alone (n = 54), HS alone (n = 50), and standard total thyroidectomy (n = 50). The 24-hour drain output was lower in the Floseal + HS group compared with standard thyroidectomy. Floseal + HS also had a shorter surgery time (P < .0001) versus the other 3 treatments.
  
  
  CONCLUSIONS
  Floseal + HS can be effective at reducing postsurgical drain output and provides a complementary hemostatic approach in patients undergoing total thyroidectomy.
authors.affiliation: Second University of Naples, Naples, Italy giovanni.docimo@unina2.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Docimo
authors.affiliation: Second University of Naples, Naples, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Tolone
authors.affiliation: Second University of Naples, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Conzo
authors.affiliation: Second University of Naples, Naples, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Limongelli
authors.affiliation: Second University of Naples, Naples, Italy.
authors.forename: Gianmattia
authors.initials: G
authors.lastname: Del Genio
authors.affiliation: Second University of Naples, Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Parmeggiani
authors.affiliation: "A. Cardarelli" Hospital, Naples, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: De Palma
authors.affiliation: "A. Cardarelli" Hospital, Naples, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Lupone
authors.affiliation: University of Perugia, Perugia, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Avenia
authors.affiliation: University of Perugia, Perugia, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Lucchini
authors.affiliation: University of Perugia, Perugia, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Monacelli
authors.affiliation: University of Palermo, Palermo, Italy.
authors.forename: Gaspare
authors.initials: G
authors.lastname: Gulotta
authors.affiliation: University of Palermo, Palermo, Italy.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Scerrino
authors.affiliation: Second University of Naples, Naples, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Pasquali
authors.affiliation: Second University of Naples, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bellastella
authors.affiliation: Second University of Naples, Naples, Italy.
authors.forename: Katherine
authors.initials: K
authors.lastname: Esposito
authors.affiliation: Second University of Naples, Naples, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: De Bellis
authors.affiliation: University of Bari, Bari, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Pezzolla
authors.affiliation: Second University of Naples, Naples, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Ruggiero
authors.affiliation: Second University of Naples, Naples, Italy.
authors.forename: Ludovico
authors.initials: L
authors.lastname: Docimo
mesh_terms: D000328:Adult; D005260:Female; D005780:Gelatin / Q000627:therapeutic use; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013525:Surgical Instruments; D013917:Thrombin / Q000627:therapeutic use; D013965:Thyroidectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data*; D016896:Treatment Outcome
chemical_list: C411004:FloSeal Matrix; D006490:Hemostatics; D005780:Gelatin; D013917:Thrombin
keywords: Floseal; gelatin–thrombin matrix; harmonic scalpel; hemostatic agent; total thyroidectomy