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The efficacy of a thrombin-based hemostatic agent in primary total knee arthroplasty: a meta-analysis.
- Source :
-
Journal of orthopaedic surgery and research [J Orthop Surg Res] 2014 Oct 15; Vol. 9, pp. 90. Date of Electronic Publication: 2014 Oct 15. - Publication Year :
- 2014
-
Abstract
- Purpose: Total knee arthroplasty (TKA) is a popular procedure in severe osteoarthritis. But perioperative bleeding remains a problem. Floseal® is a mixture of thrombin and bovine gelatin which can benefit a lot on reducing intraoperative and postoperative bleeding. However, there is no enough evidence judging its safety and efficiency. So a meta-analysis is conducted by us to evaluate the efficacy and safety of a thrombin-based hemostatic agent compared with conventional methods in TKA.<br />Method: Two independent reviewers selected literatures published before August 2014 from MEDLINE, Embase, and The Cochrane Central Register of Controlled Trials. Other internet databases were also performed to identify trials according to the Cochrane Collaboration guidelines. High-quality randomized controlled trials (RCTs), prospective control trials (PCTs), and case controlled trials (CCTs) were selected. The meta-analysis was undertaken using RevMan 5.1 for Windows.<br />Results: Three RCTs, one PCT, and one CCT met the inclusion criteria. There were significant differences in hemoglobin decline and calculated total blood loss between the Floseal® group and control group. There were no significant differences in postoperative drainage volume, rate of transfusion requirement, incidence of wound infection, deep vein thrombosis (DVT), and pulmonary embolism (PE) between treatment and control groups.<br />Conclusions: The present meta-analysis indicates that a thrombin-based hemostatic agent can reduce hemoglobin decline and calculated total blood loss after TKA and is not related to adverse reactions or complications such as wound infection, DVT, and PE.
- Subjects :
- Arthroplasty, Replacement, Knee adverse effects
Gelatin Sponge, Absorbable adverse effects
Hemostatics adverse effects
Humans
Treatment Outcome
Arthroplasty, Replacement, Knee methods
Blood Loss, Surgical prevention & control
Gelatin Sponge, Absorbable therapeutic use
Hemostatics therapeutic use
Postoperative Hemorrhage prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1749-799X
- Volume :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of orthopaedic surgery and research
- Publication Type :
- Academic Journal
- Accession number :
- 25316253
- Full Text :
- https://doi.org/10.1186/s13018-014-0090-7