Polysaccharide hemostatic system reduces blood loss in high-body-mass-index patients undergoing simultaneous bilateral total knee arthroplasty
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To investigate the efficacy of a topically applied hemostatic agent used to reduce blood loss in patients undergoing simultaneous bilateral total knee arthroplasty (TKA).
Thirty-two patients (5 male, 27 female) mean age 65 ± 9.3 (46–80) undergoing single-stage bilateral TKA were enrolled in the study and divided in two groups. Groups 1 and 2 consisted of patients with body mass index (BMI) <30 and >30, respectively. Polysaccharide hemostatic agent (PHA; 3 g) was applied topically to the right knees of each patient intraoperatively. The left knees were used as controls. A negative suction drain was used and the effect of PHA and BMI on postoperative bleeding was evaluated.
Blood loss was significantly higher (p = 0.027, r = 0.397) for patients with higher BMI. Treatment by local application of PHA to potential bleeding sites significantly reduced blood loss—314 ± 151 ml (50–600) for the right knees versus 468 ± 140 ml (150–700) for the left knees (p = 0.007) in group 1; 420 ± 251 ml (100–900) for the right knees versus 620 ± 229 ml (350–1125) for the left knees (p = 0.036) in group 2. Blood loss reduction between the right and left knees was no different between the two groups (p = 0.173).
By reducing blood loss and the need for postoperative blood transfusion in patients with high BMI, PHA can be of value as adjuvant therapy in new blood-management procedures in major joint-replacement surgery.
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- Polysaccharide hemostatic system reduces blood loss in high-body-mass-index patients undergoing simultaneous bilateral total knee arthroplasty
Journal of Orthopaedic Science
Volume 17, Issue 4 , pp 432-436
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- 1. Department of Orthopaedics, Ankara Onkoloji Training and Research Hospital, 2. Ortopedi Klinigi, Demetevler, Ankara, Turkey
- 2. Department of Orthopaedics, Cukurova University School of Medicine, Adana, Turkey