The use of ARTISS fibrin sealant in thyroid surgery: case series and review of the literature.

Abstract

Introduction Many techniques have been described to reduce length of stay and complication rates in thyroid surgery. ARTISS is a fibrin sealant used as an adjunct to sutures or staples, whereby it simultaneously adheres and seals subcutaneous tissues. In the context of thyroid surgery, it can augment the closure of dead space beneath the strap muscles and the platysma flaps. Methods A single surgeon adopted this novel technique from February 2017. A retrospective audit of 72 thyroid cases using ARTISS was conducted. Data were collected on patient demographics, ASA grade, procedure, histology, drain insertion and output, length of stay and complications. Results 71 (99%) patients had a drain inserted. Of the 57 hemithyroidectomies, 13 (23%) patients had their drain removed and were discharged on the same day, 41 (65%) the next day and 3 (6%) remained at 2 days post-operatively. Of the 41 hemithyroidectomies who stayed one night, 21 (51%) patients had been operated on in the afternoon and were discharged the following morning. Of the 15 total thyroidectomies, 9 (60%) patients had their drain removed the following day and 6 (40%) at 2 days post-operatively. There was one post-operative superficial haematoma which did not require re-operation, another which required aspiration only, and one case of suspected wound infection treated with oral antibiotics. Conclusion The use of ARTISS fibrin sealant in this case series has been shown to be a safe and successful technique. Most patients are discharged within 24 hours of surgery and no cases required a return to theatre.