Effect of fibrin vs cellulose based haemostatic agents with traditional haemostatic procedures in thyroid surgery

• Published in: Pakistan journal of medical sciences 2017-12, Vol.33 (6), p.1360-1365
• Main Authors: Aleksandar, Karanikolic, Miodagl, Djordjevic, Nebojsa, Djordjevic, Ilija, Golubovic
• Format: Article
• Language: English
• Subjects: Cellulose; Clinical medicine; Collagen; Edema; Fibrin; Hemostatic agents; Original; Surgeons; Surgery; Surgical clinics; Surgical outcomes; Systematic review; Thyroid gland
• ISSN: 1682-024X; 1681-715X
• DOI: 10.12669/pjms.336.13692

To compare the efficacy of fibrin-based hemostat and cellulose-based hemostat with traditional procedures in patients undergoing thyroid surgery. Between January 2012 and December 2016, 255 patients were scheduled to undergo total thyroidectomy at Surgical Clinic Nis. The patients were randomized to: Group-I use of classic surgical procedures to achieve hemostasis, Group-II use Surgicel and Group-III use Beriplas. A statistically significant reduction of surgical time was found for Group-I compared with Group-II and III (p≤0.01 for both groups). Statistically significant reduction of intraoperative blood loss was found for Group-I compared with Group-II from 102.3mL vs. 86.1mL (p≤0.01) as well as compared to Group-III (mean 77.4mL, p≤0.01). Removal of the wound drain occurred sooner in the Group-II and III compared with Group-I (mean 37.1h vs. 40.1h, p≤0.05; mean 31.2h vs. 40.1h, p≤0.01). There were no significant differences in terms of postoperative morbidity among the groups. Fibrin based haemostat seems to be an effective hemostatic agent for patients undergoing thyroid surgery. We suggest that, where appropriate, this fibrin-based haemostat should be used as a first line hemostatic agent in thyroidectomy in combination with conventional surgical means of hemostasis.