Comparison of Floseal (R) and Tranexamic Acid for Bleeding Control after Total Knee Arthroplasty: a Prospective Randomized Study

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author HELITO, Camilo Partezani FMUSP-HC
BONADIO, Marcelo Batista FMUSP-HC
SOBRADO, Marcel Faraco FMUSP-HC
GIGLIO, Pedro Nogueira FMUSP-HC
PECORA, Jose Ricardo FMUSP-HC
CAMANHO, Gilberto Luis FMUSP-HC
DEMANGE, Marco Kawamura FMUSP-HC
dc.date.issued 2019
dc.identifier.citation CLINICS, v.74, article ID e1186, 5p, 2019
dc.identifier.issn 1807-5932
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/34484
dc.description.abstract OBJECTIVE: Tranexamic acid (TXA) and the hemostatic agent Floseal (R) have already been used to minimize bleeding during total knee arthroplasty (TKA). METHODS: We conducted a prospective, randomized study of 90 patients with indications for TKA. Following inclusion, the participants were randomly allocated in blocks to the following 3 groups: control, Floseal (R) and TXA. Bleeding parameters, including decreases in hemoglobin (Hb), drain output, number of blood transfusions and complications, were assessed. ClinicalTrials.gov: NCT02152917. RESULTS: The mean decrease in Hb was highest in the control group (4.81 +/- 1.09 g/dL), followed by the Floseal (R) (3.5 +/- 1.03 g/dL) and TXA (3.03 +/- 1.2 g/dL) groups. The Floseal (R) and TXA groups did not differ, and both performed better than the control group. The mean total drain output was 901.3 +/- 695.7 mL in the control group, 546.5 +/- 543.5 mL in the TXA group and 331.2 +/- 278.7 mL in the Floseal (R) group. Both TXA and Floseal (R) had significantly less output than the control group, and Floseal (R) had significantly less output than TXA. The number of blood transfusions was very small in all 3 groups. CONCLUSION: The use of TXA or Floseal (R) was associated with less blood loss than that of the control group among patients undergoing primary TKA, as measured both directly (intraoperative bleeding + drainage) and on the basis of a decrease in Hb, without differences in the rate of complications. TXA and Floseal (R) showed similar decreases in Hb and total measured blood loss, but the drain output was smaller in the Floseal (R) group.
dc.language.iso eng
dc.publisher HOSPITAL CLINICAS, UNIV SAO PAULO
dc.relation.ispartof Clinics
dc.rights openAccess
dc.subject Total Knee Arthroplasty; Bleeding Control; Tranexamic Acid; Hemostatic; Transfusion Rate
dc.subject.other reduce blood-loss; hemostatic agent; clinical-trial; united-states; matrix; sealant; transfusions; metaanalysis; efficacy; surgery
dc.title Comparison of Floseal (R) and Tranexamic Acid for Bleeding Control after Total Knee Arthroplasty: a Prospective Randomized Study
dc.type article
dc.rights.holder Copyright HOSPITAL CLINICAS, UNIV SAO PAULO
dc.description.group LIM/41
dc.identifier.doi 10.6061/clinics/2019/e1186
dc.identifier.pmid 31778430
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author HELITO, Camilo Partezani:HC:IOT
hcfmusp.author BONADIO, Marcelo Batista:HC:IOT
hcfmusp.author SOBRADO, Marcel Faraco:FM:
hcfmusp.author GIGLIO, Pedro Nogueira:HC:IOT
hcfmusp.author PECORA, Jose Ricardo:HC:IOT
hcfmusp.author CAMANHO, Gilberto Luis:FM:MOT
hcfmusp.author DEMANGE, Marco Kawamura:FM:MOT
hcfmusp.origem.id WOS:000499794800001
hcfmusp.origem.id 2-s2.0-85075618061
hcfmusp.publisher.city SAO PAULO
hcfmusp.publisher.country BRAZIL
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dc.description.index MEDLINE
dc.identifier.eissn 1980-5322
hcfmusp.citation.wos 0


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