title: Reduction of transfusion requirements in pediatric craniosynostosis surgery by a new local hemostatic agent.
abstract: OBJECTIVE
  Craniosynostosis surgery is often associated with severe perioperative bleeding especially due to venae emissariae, resulting in large transfusion amounts of packed red blood cells (PRBCs). Blood loss from venae emissariae is usually reduced by the usage of bone wax. SeraSeal is a new hemostatic agent which might help to reduce transfusion amounts if used additionally to bone wax.
  
  
  METHODS
  This study was designed with a retrospective control group (23 children), treated only with bone wax and a consecutive prospective verum group (12 children) treated additionally with SeraSeal. All children solely suffered from non-syndromic craniosynostosis, and were all treated by the same surgeons. Primary outcome variable was the volume of PRBC transfused during surgery.
  
  
  RESULTS
  The numbers of PRBC transfusion was reduced significantly during the intraoperative period in the SeraSeal group (-44.5%, p < 0.05) and also during the combination of the postoperative and intraoperative period (-59.3%, p < 0.05).
  
  
  CONCLUSIONS
  Our analysis suggests that SeraSeal has a strong potential to reduce transfusion requirements in pediatric craniosynostosis surgery. However, we acknowledge that due to small numbers our trial can only be seen as hypothesis generating pilot study. We suggest that the effect of SeraSeal should be assessed prospectively in other studies.
authors.affiliation: Department of Cranio-Maxillofacial Surgery (Head: Dr. M. Malek), Faculty of Medicine of the Kepler University Linz, Krankenhausstraße 9, 4020 Linz, Austria.
authors.forename: Raphael
authors.initials: R
authors.lastname: Stehrer
authors.affiliation: Department of Cranio-Maxillofacial Surgery (Head: Dr. M. Malek), Faculty of Medicine of the Kepler University Linz, Krankenhausstraße 9, 4020 Linz, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hunger
authors.affiliation: Department of Cranio-Maxillofacial Surgery (Head: Dr. M. Malek), Faculty of Medicine of the Kepler University Linz, Krankenhausstraße 9, 4020 Linz, Austria.
authors.forename: Klaus-Jürgen
authors.initials: KJ
authors.lastname: Schotten
authors.affiliation: Department of Cranio-Maxillofacial Surgery (Head: Dr. M. Malek), Faculty of Medicine of the Kepler University Linz, Krankenhausstraße 9, 4020 Linz, Austria.
authors.forename: Babak
authors.initials: B
authors.lastname: Parsaei
authors.affiliation: Department of Cranio-Maxillofacial Surgery (Head: Dr. M. Malek), Faculty of Medicine of the Kepler University Linz, Krankenhausstraße 9, 4020 Linz, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Malek
authors.affiliation: Department of Cranio-Maxillofacial Surgery (Head: Dr. M. Malek), Faculty of Medicine of the Kepler University Linz, Krankenhausstraße 9, 4020 Linz, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Jacob
authors.affiliation: Department of Cranio-Maxillofacial Surgery (Head: Dr. M. Malek), Faculty of Medicine of the Kepler University Linz, Krankenhausstraße 9, 4020 Linz, Austria.
authors.forename: Gertraud
authors.initials: G
authors.lastname: Geiselseder
authors.affiliation: Department of Cranio-Maxillofacial Surgery (Head: Dr. M. Malek), Faculty of Medicine of the Kepler University Linz, Krankenhausstraße 9, 4020 Linz, Austria. Electronic address: jens.meier@gmail.com.
authors.forename: Jens
authors.initials: J
authors.lastname: Meier
mesh_terms: D000362:Agar; D001779:Blood Coagulation Factors; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D003398:Craniosynostoses / Q000601:surgery*; D004338:Drug Combinations; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D010168:Palmitates; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome; D014885:Waxes
chemical_list: D001779:Blood Coagulation Factors; D004338:Drug Combinations; D006490:Hemostatics; D010168:Palmitates; C000624544:SeraSeal; D014885:Waxes; C055480:bone wax; D000362:Agar
keywords: Craniosynostosis; Patient Blood Management; RBC transfusion; SeraSeal; Topical hemostasis; Transfusion