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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 3, 306-309.
doi: 10.1302/0301-620X.89B3.17565  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Comparison of topical fibrin spray and tranexamic acid on blood loss after total knee replacement

A PROSPECTIVE, RANDOMISED CONTROLLED TRIAL

D. O. Molloy, MRCSI, MPhil, Orthopaedic Registrar1; H. A. P. Archbold, MRCS, Orthopaedic Registrar1; L. Ogonda, MRCS, MPhil, Orthopaedic Registrar1; J. McConway, MRCS, Arthroplasty Research Fellow1; R. K. Wilson, FRCS, MPhil, Orthopaedic Registrar1; and D. E. Beverland, MD, FRCS, Consultant Orthopaedic Surgeon1

1 Orthopaedic Outcomes Department, Musgrave Park Hospital, Stockmans Lane, Belfast, BT9 7JB, Northern Ireland.

Correspondence should be sent to Mr D. O. Molloy; e-mail: dennis.molloy{at}greenpark.n-i.nhs.uk

We performed a randomised, controlled trial involving 150 patients with a pre-operative level of haemoglobin of 13.0 g/dl or less, to compare the effect of either topical fibrin spray or intravenous tranexamic acid on blood loss after total knee replacement.

A total of 50 patients in the topical fibrin spray group had 10 ml of the reconstituted product applied intra-operatively to the operation site. The 50 patients in the tranexamic acid group received 500 mg of tranexamic acid intravenously five minutes before deflation of the tourniquet and a repeat dose three hours later, and a control group of 50 patients received no pharmacological intervention.

There was a significant reduction in the total calculated blood loss for those in the topical fibrin spray group (p = 0.016) and tranexamic acid group (p = 0.041) compared with the control group, with mean losses of 1190 ml (708 to 2067), 1225 ml (580 to 2027), and 1415 ml (801 to 2319), respectively. The reduction in blood loss in the topical fibrin spray group was not significantly different from that achieved in the tranexamic acid group (p = 0.72).




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eLetters:

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Comparison of topical fibrin spray and tranexamic acid on blood loss after total knee replacement
Neil Orpen
J Bone Joint Surg Br Online, 18 Apr 2007 [Full text]
Comparison of topical fibrin spray and tranexamic acid on blood loss after total knee replacement
Benedict A Rogers, et al.
J Bone Joint Surg Br Online, 9 May 2007 [Full text]

(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General