Effect of fibrin sealant on blood loss following total knee arthroplasty: A systematic review and meta-analysis

Li, Jun; Cao, Jun; Wang, Lei; Ma, Xinlong

doi:10.1016/j.ijsu.2013.11.011

Cited by 25 publications

(14 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many studies have proved their efficacy without increasing the risk of DVT, PE, hematoma, wound infection or other complications for patients undergoing TKA[101,102]. However, their main disadvantage is the high cost compared to other blood management methods (like TXA)[103,104].…”

Section: Intra-operativementioning

confidence: 99%

Perioperative blood management strategies for patients undergoing total knee replacement: Where do we stand now?

Themistoklis¹,

Vogiatzaki²,

Kazakos³

et al. 2017

WJO

View full text Add to dashboard Cite

Total knee replacement (TKR) is one of the most common surgeries over the last decade. Patients undergoing TKR are at high risk for postoperative anemia and furthermore for allogeneic blood transfusions (ABT). Complications associated with ABT including chills, rigor, fever, dyspnea, light-headedness should be early recognized in order to lead to a better prognosis. Therefore, perioperative blood management program should be adopted with main aim to reduce the risk of blood transfusion while maximizing hemoglobin simultaneously. Many blood conservation strategies have been attempted including preoperative autologous blood donation, acute normovolemic haemodilution, autologous blood transfusion, intraoperative cell saver, drain clamping, pneumatic tourniquet application, and the use of tranexamic acid. For practical and clinical reasons we will try to classify these strategies in three main stages/pillars: Pre-operative optimization, intra-operative and post-operative protocols. The aim of this work is review the strategies currently in use and reports our experience regarding the perioperative blood management strategies in TKR.

show abstract

Section: Intra-operativementioning

confidence: 99%

Perioperative blood management strategies for patients undergoing total knee replacement: Where do we stand now?

Themistoklis¹,

Vogiatzaki²,

Kazakos³

et al. 2017

WJO

View full text Add to dashboard Cite

show abstract

“…In a metaanalysis of eight studies involving 558 patients undergoing total knee arthroplasty, topical fibrin application reduced drainage blood loss by an average of 354 ml (95% CI 207-501), total blood loss by an average of 402 ml (95% CI 205-599) and transfusion rate (RR 0.62, 95% CI 0.45-0.86) compared with controls [50].…”

Section: Patient Blood Management and Prevention Of Anaemiamentioning

confidence: 99%

Blood conservation strategies and the management of perioperative anaemia

Shander

Javidroozi

2015

Current Opinion in Anaesthesiology

View full text Add to dashboard Cite

show abstract

“…Meta-analyses offer contradictory conclusions as to whether fibrin sealant reduces total blood loss; however, there may be a reduction in drain output and transfusion rate without an increased risk of complications 70. Fibrin sealant is not as effective as tranexamic acid at reducing blood loss71 and given the high additional cost, the role of fibrin sealant in a multimodal blood management algorithm is uncertain.…”

Section: Intraoperativementioning

confidence: 99%

Blood management in total knee arthroplasty: state-of-the-art review

et al. 2018

View full text Add to dashboard Cite

Total blood loss from primary total knee arthroplasty may exceed 2 L with greater blood loss during revision procedures. Blood loss and allogeneic transfusion are strongly associated with adverse outcomes from surgery including postoperative mortality, thromboembolic events and infection. Strategies to reduce blood loss and transfusion rates improve patient outcomes and reduce healthcare costs. Interventions are employed preoperatively, intraoperatively and postoperatively. The strongest predictor for allogeneic blood transfusion is preoperative anaemia. Over 35% of patients are anaemic when scheduled for primary and revision knee arthroplasty, defined as haemoglobin <130 g/L for men and women, and the majority of cases are secondary to iron deficiency. Early identification and treatment of anaemia can reduce postoperative transfusions and complications. Anticoagulation must be carefully managed perioperatively to balance the risk of thromboembolic event versus the risk of haemorrhage. Intraoperatively, tranexamic acid reduces blood loss and is recommended for all knee arthroplasty surgery; however, the optimal route, dose or timing of administration remains uncertain. Cell salvage is a valuable adjunct to surgery with significant expected blood loss, such as revision knee arthroplasty. Autologous blood donation is not recommended in routine care, sealants may be beneficial in select cases but further evidence of benefit is required, and the use of a tourniquet remains at the discretion of the surgeon. Postoperatively, restrictive transfusion protocols should be followed with a transfusion threshold haemoglobin of 70 g/L, except in the presence of acute coronary syndrome. Recent studies report no allogeneic transfusions after primary knee arthroplasty surgery after employing blood conservation strategies. The current challenge is to select and integrate different blood conserving interventions to deliver an optimal patient pathway with a multidisciplinary approach.

show abstract

Effect of fibrin sealant on blood loss following total knee arthroplasty: A systematic review and meta-analysis

Abstract: II.

Cited by 25 publications

References 29 publications

Perioperative blood management strategies for patients undergoing total knee replacement: Where do we stand now?

Perioperative blood management strategies for patients undergoing total knee replacement: Where do we stand now?

Blood conservation strategies and the management of perioperative anaemia

Blood management in total knee arthroplasty: state-of-the-art review

Contact Info

Product

Resources

About