Use of a fibrin sealant within a blood-saving protocol in patients undergoing revision hip arthroplasty: effects on post-operative blood transfusion and healthcare-related cost analysis

Scardino, Marco; Martorelli, Federica; D'Amato, Tiziana; Fenocchio, Giorgia; Simili, Vincenzo; Grappiolo, Guido; Matteo, Berardo Di; Kon, Elizaveta; Lagioia, Michele

doi:10.1007/s00264-019-04291-4

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…The recently published reports of Kehlet et al [12,15,31,39,40] point to this safe aspect of administering a single dose of methylprednisolone that is associated with a quantifiable beneficiary analgesic effect in patients after extensive orthopaedic procedures, with limited post-operative complications [4,6,7,10,15,18,22,27,[31][32][33].…”

Section: Discussionmentioning

confidence: 99%

The effect of pre-operative high doses of methylprednisolone on pain management and convalescence after total hip replacement in elderly: a double-blind randomized study

Gądek

Liszka

Zając

2020

International Orthopaedics (SICOT)

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Purpose The aim of the study was to assess whether administration of a single dose of methylprednisolone in the group patients above 65 years of age will be effective in complex analgesic management after total hip arthroplasty (THA). Methods Seventy-seven patients above 65 years old were double-blind randomized into two: the study and controls groups. Pre-operatively, the study group received as a single dose of 125 mg intravenous methylprednisolone, while the others saline solution as placebo. Peri-operatively, all the patients were administered opioid and nonopioid analgesic agents. We measured the levels of inflammatory markers (leukocytosis, C-reactive protein—CRP), pain intensity level (visual analog scale—VAS; numerical rating scale—NRS), the life parameters, and noted complications. Results Following administration of methylprednisolone were significantly lower levels of CRP on all the four post-operative days; leukocytosis on the second day; the VAS/NRS score at rest after six, 12, and 18 hours post-operatively, diminished the dose of parenteral opioid preparations (oxycodone hydrochloride), the duration of analgesia by peripheral nerve block was significantly higher as compared with the placebo group (p < 0.000001). No infectious complications were noted; there was one patient who developed post-operative delirium. Conclusion A single dose of methylprednisolone significantly reduces the level of post-operative pain at rest on the day of THA in the group patients above 65 years of age, decreases the dose of opioid analgesic agents, and significantly decreases the level of inflammatory markers, without infectious processes.

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Section: Discussionmentioning

confidence: 99%

The effect of pre-operative high doses of methylprednisolone on pain management and convalescence after total hip replacement in elderly: a double-blind randomized study

Gądek

Liszka

Zając

2020

International Orthopaedics (SICOT)

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“…In response to these problems, medical adhesives came into being. Fibrin glue, gelatin resorcinol and cyanoacrylate are all types of medical adhesives currently being used clinically [3][4][5][6][7][8][9][10]. However, due to its limited adhesive ability, there are still defects in clinical applications [11].…”

Section: Introductionmentioning

confidence: 99%

Controllable performance of a dopamine-modified silk fibroin-based bio-adhesive by doping metal ions

et al. 2021

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Bio-adhesives are essential for wound healing because of their convenience and safety. Although widely used as biomaterials, silk fibroin’s (SF’s) further application as bio-adhesive is hindered due to its weak stickiness with tissue and slow gelation speed. Here, a dopamine-modified SF-based bio-adhesive is fabricated by using genipin as the chemical cross-linking agent. Furthermore, metal ions have been used to adjust the adhesion property of the bio-adhesive. The experimental results shows that the dopamine-modified SF-based composite holds a better stickiness except slow gelation speed. The doping of Cu2+ and Fe3+ can accelerate the gelation of the bio-adhesive. Compared with Cu2+, Fe3+ has a stronger effect on the gelation speed of the bio-adhesive, which is positive correlative to the concentration of Fe3+. The adhesive has injectability and degradability. In addition, the SF-based adhesive has good biocompatibility and good improvement for cell migration in vitro. The SF-based bio-adhesive holds potential application in the field of rapid fixation of wounds.

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“…Inclusion of a fibrin sealant may significantly reduce post-operative blood transfusions and induce a faster recovery for patients undergoing complete RHA, allowing early discharge from the hospital. These advantages provide significant cost savings for both the hospital and the healthcare system (30).…”

Section: Discussionmentioning

confidence: 99%

To Revi̇se or Not to Revi̇se! That İs the Questi̇On

Dırvar¹,

Dirvar²,

Cengîz

et al. 2021

Kocatepe Tıp Dergisi

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Bir kamu hastanesinin ortopedi ve travmatoloji kliniğinde kalça revizyon artroplasti ameliyatı yapılan hastaların yatarak tedavi gördüğü süreçte, kurumca katlanılan maliyetlerinin araştırılması ve fatura edilen miktar ile karşılaştırılması amaçlanmıştır.GEREÇ VE YÖNTEM: 01.01.2016 ile 30.09.2017 tarihleri arasında bir kamu hastanesinde total kalça revizyon artroplastisi ameliyatı yapılan 60 hastanın demografik bilgileri ve revizyon nedenleri tespit edilmiştir. Hastalar septik ve aseptik olarak iki gruba ayrılmıştır. Hastaların, yatarak tedavi gördüğü sürece katlanılan tıbbi sarf, ilaç/serum, tedavi, ameliyat, anestezi, görüntüleme, laboratuvar, kan ve kan ürünleri, yemek, refakatçı maliyetleri, cihaz amortisman giderleri, konsültasyon, kontrol muayenesi, ameliyat öncesi hasta hazırlık aşaması, vizit ve diğer maliyetleri her bir hasta için ayrı ayrı hesaplanmıştır. BULGULAR:Bir hastanın toplam maliyeti ortalama 21.956,00 ₺ iken fatura tutarı ortalama 17.220,00 ₺ tespit edilmiş olup arada 4.736,00 ₺ fark bulunmaktadır. Bu fark septik gruptaki hastalarda 9.876,00 ₺, aseptik gruptaki hastalarda 2.534,00 ₺ olarak tespit edilmiştir. SGK'nın kuruma yaptığı fatura ödemesi, revizyon kalça artroplastisi maliyetinin% 78,4'ünü kapsıyor. Septik grupta yatış süresi, tıbbi sarf, ilaç, tedavi, ameliyat, anestezi, laboratuvar, görüntüleme, kan merkezi, konsültasyon, vizit, yemek maliyeti, toplam maliyet ve fatura tutarı aseptik gruptan anlamlı (p< 0.05) olarak daha yüksek bulunmuştur. SONUÇ: Kamu hastanesinin mali sürdürebilirliğinin sağlanması için SGK tarafından düzenlemelerin yapılmasına ihtiyaç bulunmaktadır. Ayrıca, revizyon cerrahisinde medikal ve teknik protokolleri takip edilmesi maliyetin azalmasına yardımcı olabilir.

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Use of a fibrin sealant within a blood-saving protocol in patients undergoing revision hip arthroplasty: effects on post-operative blood transfusion and healthcare-related cost analysis

Cited by 7 publications

References 30 publications

The effect of pre-operative high doses of methylprednisolone on pain management and convalescence after total hip replacement in elderly: a double-blind randomized study

The effect of pre-operative high doses of methylprednisolone on pain management and convalescence after total hip replacement in elderly: a double-blind randomized study

Controllable performance of a dopamine-modified silk fibroin-based bio-adhesive by doping metal ions

To Revi̇se or Not to Revi̇se! That İs the Questi̇On

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