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KMID : 1189320150090060909
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Asian Spine Journal
2015 Volume.9 No. 6 p.909 ~ p.915
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Efficacy of a Topical Gelatin-Thrombin Matrix Sealant in Reducing Postoperative Drainage Following Anterior Cervical Discectomy and Fusion
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Li Quan You
Lee O-Sung
Han Ho-Sung
Kim Gang-Un
Lee Chee Kean
Kang Sung-Shik
Lee Myung-Ho
Cho Hyeon-Guk
Kim Ho-Joong
Yeom Jin-S.
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Abstract
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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 ≤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 ≤10 mL was significantly lower in the study group (10±5 versus 26±14 hours, p<0.001). The 8-hour drainage decreased to ≤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.
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KEYWORD
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Cervical vertebrae, Hemostasis, Postoperative hemorrhage, Floseal matrix, Spinal fusion
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