title: The efficiency and safety of fibrin sealant for reducing blood loss in primary total hip arthroplasty: A systematic review and meta-analysis.
abstract: OBJECTIVE
  Total hip arthroplasty (THA) is associated with substantial blood loss. The objective of present systematic review and meta-analysis is to provide evidence from randomized controlled trials (RCTs) on the efficiency and safety of administration of fibrin sealant (FS) for reducing blood loss in patients undergoing primary THA.
  
  
  METHODS
  Potential relevant studies were identified from electronic databases including Medline, PubMed, Embase, ScienceDirect, web of science and Cochrane Library. Gray academic studies were also identified from the reference list of included studies. There was no language restriction. Pooling of data was carried out by using RevMan 5.1.
  
  
  RESULTS
  Six randomized controlled trials (RCTs) met the inclusion criteria. Current meta-analysis indicated that there were significant differences in terms of total blood loss (MD = -153.77, 95% CI: -287.21 to -20.34, P = 0.02), postoperative hemoglobin level (MD = -0.25, 95% CI: -0.46 to -0.05, P = 0.02) and transfusion rate (RD = -0.12, 95% CI: -0.22 to -0.03, P = 0.01) between groups. No significant differences were found regarding the incidence of deep venous thrombosis (DVT) (RD = 0.00, 95% CI: -0.01to 0.01, P = 0.51) or other side effects.
  
  
  CONCLUSIONS
  Administration of fibrin sealant in total hip arthroplasty may reduce total blood loss, postoperative hemoglobin decline and transfusion requirements. Moreover, no adverse effect was related to FS. Due to the limited quality of the evidence currently available, higher quality RCTs are required.
authors.affiliation: Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, 710054, PR China.
authors.forename: Zhiyuan
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, 710054, PR China.
authors.forename: Lin
authors.initials: L
authors.lastname: Xiao
authors.affiliation: Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, 710054, PR China.
authors.forename: Hao
authors.initials: H
authors.lastname: Guo
authors.affiliation: Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, 710054, PR China.
authors.forename: Guanghui
authors.initials: G
authors.lastname: Zhao
authors.affiliation: Hong-Hui Hospital, Xi'an Jiaotong University College of Medicine, 710054, PR China. Electronic address: 13299028888@163.com.
authors.forename: Jianbing
authors.initials: J
authors.lastname: Ma
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006454:Hemoglobins / Q000032:analysis; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D011184:Postoperative Period; D016032:Randomized Controlled Trials as Topic
chemical_list: D015718:Fibrin Tissue Adhesive; D006454:Hemoglobins; D006490:Hemostatics
keywords: Blood loss; Fibrin sealant; Meta-analysis; Total hip arthroplasty