The Ambiguous Role of Hemostatic Matrix in Total Knee Arthroplasty: A Randomized Controlled Trial

Vol 31 | Issue 1 | Jan – Jun 2018 | page: 15-18 | Appu Benny Thomas, Jacob Varghese, Gnanavel, J C Vinay, Biju Pankappilly.


Authors: Appu Benny Thomas [1], Jacob Varghese [1], Gnanavel [1], J C Vinay [1], Biju Pankappilly [1]

[1] Department of Orthopedics, VPS Lakeshore Hospital and Research Center, Kochi, Kerala, India.

Address of Correspondence
Dr. Appu Benny Thomas
Department of Orthopedics,
VPS Lakeshore Hospital and Research Center, Kochi, Kerala, India
E-mail: appu.benny.thomas@gmail.com


Abstract

Background: Blood loss which is one of the major complications following major surgeries and leads to significant morbidity and substantially increases the need for blood transfusions. Use of hemostatic agent’s intraoperatively is one of the widely used techniques to reduce blood loss. The use of hemostatic agents to reduce blood loss has been widely studied with mixed results. The aim of this study was to evaluate whether the use of Floseal®, a hemostatic most commonly used in our hospital as an adjuvant to conventional hemostasis reduces blood loss and reduces the requirement of transfusions postoperatively in patients undergoing total knee arthroplasty (TKA).
Materials and Methods: This study was a prospective randomized controlled trial conducted on 67 female patients operated between January 2012 and January 2013 with the primary endpoint being blood loss as estimated by a decrease in hemoglobin (Hb) on days 0, 1, and 4 postoperatively. The number of transfusions required postoperatively was also assessed. The patients were divided into two groups: Group A and Group B. Group A consisted of 35 patients in whom the hemostatic was not used. Group B consisted of 32 patients in whom 5ml of hemostatic matrix Floseal®. All the statistical analyses were performed using GraphPad Prism 7.0. Results: Sixty-seven patients participated in the study, and the data of all the patients were analyzed. The demographic data and the mean percentage decrease of Hb from pre-operative values were analyzed which did not show any statistical difference. The odds ratio and relative risk were less than one and were not statistically significant.
Conclusion: The use of a hemostatic agent does not necessarily decrease the need for blood transfusions postoperatively, and the role of hemostatic agents in TKA for reducing blood loss remains uncertain.
Keywords: Blood transfusion, Hemostatic Matrix, Total Knee Arthroplasty.


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How to Cite this Article: Thomas A B, Varghese J, Gnanavel, Vinay J C, Pankappilly B. The Ambiguous Role of Hemostatic Matrix in Total Knee Arthroplasty: A Randomized Controlled Trial. Kerala Journal of Orthopaedics Jan- Jun 2018;31(1):12-15 .

 


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