Efficacy of a Topical Gelatin-Thrombin Matrix Sealant in Reducing Postoperative Drainage Following Anterior Cervical Discectomy and Fusion.
- Author:
Quan You LI
1
;
Osung LEE
;
Ho Sung HAN
;
Gang Un KIM
;
Chee Kean LEE
;
Sung Shik KANG
;
Myung Ho LEE
;
Hyeon Guk CHO
;
Ho Joong KIM
;
Jin S YEOM
Author Information
- Publication Type:Original Article
- Keywords: Cervical vertebrae; Hemostasis; Postoperative hemorrhage; Floseal matrix; Spinal fusion
- MeSH: Cervical Vertebrae; Diskectomy*; Drainage*; Female; Hematoma; Hemostasis; Humans; Postoperative Hemorrhage; Retrospective Studies; Spinal Fusion
- From:Asian Spine Journal 2015;9(6):909-915
- CountryRepublic of Korea
- Language:English
- Abstract: STUDY DESIGN: Retrospective fusion level(s)-, age-, and gender-matched analysis. PURPOSE: To determine whether the application of a topical gelatin-thrombin matrix sealant (Floseal) at the end of anterior cervical discectomy and fusion (ACDF) can reduce the amount of postoperative hemorrhage. OVERVIEW OF LITERATURE: The effect of the matrix sealant in decreasing postoperative hemorrhage following ACDF has not been reported. METHODS: Matrix sealant was (n=116, study group) or was not applied (n=58, control group) at the end of ACDF. Patients were selected by 1:2 matching criteria of fusion level(s), age, and gender. Seven parameters described below were compared between the two groups. RESULTS: The total drain amount for the first 24 hours (8+/-9 versus 27+/-22 mL), total drain amount until the 8-hour drainage decreased to < or =10 mL (8+/-10 versus 33+/-26 mL), and the total drain amount until 6 AM on the first postoperative day (7+/-8 versus 24+/-20 mL) were significantly lower in the study group than the control group (all p<0.001). The time for the 8-hour drainage to decrease to < or =10 mL was significantly lower in the study group (10+/-5 versus 26+/-14 hours, p<0.001). The 8-hour drainage decreased to < or =10 mL on the operation day in most patients (88%) in the study group versus mostly on the first (48%) or second (33%) postoperative day in the control group (p<0.001). The total drain amount until 6 AM on the first postoperative day was 0 mL in 43% of patients in the study group and in 7% in the control group (p<0.001). No patient in either group required hematoma evacuation. CONCLUSIONS: Application of the topical matrix sealant at the end of ACDF can significantly reduce the amount of postoperative hemorrhage.
