Object. Failed-back syndrome is still an unsolved problem. Use of ADCON-L gel, already commercially available, has been proven to reduce postoperative scarring in animal experiments. The authors of two controlled clinical studies have also shown positive results when applying the gel. They did not, however, establish patient-oriented endpoints. The authors report a study of ADCON-L in which they focus on patient-oriented endpoints. Methods. Patients with lumbar disc herniation were randomized to an ADCON-L—treated or control group. Therapeutic success was evaluated using the validated Hannover Questionnaire on Activities of Daily Living (FFbH) 6 months after surgery. The study took place between November 14, 1996, and April 20, 1998, in eight neurosurgical centers in Germany. A total of 398 patients was recruited; 41 patients dropped out during follow up. The mean functional FFbH score (100 points = all activities are possible without problem; 0 points = no activity is possible) was 78.5 points in the ADCON-L—treated group compared with 80 points in the control group. Furthermore, in terms of secondary outcome variables, the ADCON-L group did not have an advantage over the control group. Only the mean magnetic resonance imaging score showed a slight advantage of ADCON-L over the control group. Conclusions. The authors found no positive effect of treatment with ADCON-L gel in patients in whom one-level lumbar microdiscectomy was performed. Because of its rather large sample size and its homogeneity, the study had sufficient power to detect even small differences between the two groups.

The procurement of some advanced blood components, like quarantined plasma units, depends critically on retesting the donor within a fixed time frame. For health care systems, such as that in Germany, with mandatory retesting of donors before plasma release, the reliable identification of donors who are more likely to return in time has an immense practical implication, because their blood components could be preferably selected for quarantine purposes. The donation histories of about 760 000 donors with 4910 000 donation attempts were analysed. We developed a logistic regression model to calculate a probability of donation, p(Dts-te), within a preselected time frame (ts-te). The donation history was compounded in a score and shown to be very useful for determining p(Dts-te). A logistic regression model was developed with score and donor status as parameters; different regression coefficients applied to first-time-donors (ftd) and to repeat donors (intercept, int, and score factor, scf ). This model allowed us to determine the probability of donation, p(Dts-te), within a preselected time interval, e.g. 6-9 months after an index donation. The p(Dts-te) can be calculated for any donor of blood services. The p(D170-275 days) ranged from about 22% to 86% for any index donation in 1996/97. First-time donors had a p(D170-275 days) of 33% and were more likely to return within the time interval than certain subsets of repeat donors who can be defined by our model. We provided a technical procedure to increase the rate of plasma unit release after quarantine storage and showed the usefulness of our procedure for blood component management, if quarantine storage is required. By applying the model to our current plasma quarantine programme we could retrieve about 30% more units, which would represent about 30 000 units per year, without incurring additional costs. General implications for blood collection, like planning blood drives, were discussed. The whole demand of a health care system for single plasma units may be met by quarantine plasma and their cost-efficiency can be improved.

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