A Cochrane review [Abstract] 1 included 18 studies with a total of 1 406 subjects. Trials were conducted across a range of surgical settings including orthopaedic surgery (n = 7), liver surgery (n = 5), vascular surgery (n = 4), prostate surgery (n = 3), thoracic surgery (n = 3), renal surgery (n = 1), pancreatic surgery (n = 1), cardiac surgery (n = 1), and plastic surgery (incisional hernia repair with dermolipectomy) (n = 1). There was also considerable variation in the type of fibrin sealant studied.
Fibrin sealant treatment, on average, reduced the rate of exposure to allogeneic red cell transfusion by a relative 37% (RR 0.63, 95% CI 0.45 to 0.88). Fourteen trials, including a total of 853 patients, provided data for post-operative blood loss. Fibrin sealant treatment reduced blood loss on average by around 161 ml per patient (95% CI 98.25 to 224.53 ml). The greatest reductions in post-operative blood loss were observed in the seven trials that were conducted in the setting of orthopaedic surgery. Seven trials, including a total of 463 patients, reported data for intra-operative blood loss. The use of fibrin sealant did not significantly impact on intra-operative blood loss (WMD -4.51 ml, 95% CI -36.86 to 27.83 ml).
Primary/Secondary Keywords