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D Makhija, M Rock, S Ikeme, E Kuntze, J D Epstein, G Nicholson, J S Price, V Patel
OBJECTIVES: A recently published retrospective analysis comparing two different active flowable hemostatic matrices (FLOSEAL and SURGIFLO Kit with Thrombin) showed significantly increased resource use and complications (surgery time, risk of blood product transfusion, and amount of matrix used) with SURGIFLO use compared to FLOSEAL in major spine surgery, and also significantly increased surgical time with SURGIFLO use in severe spine surgery. This analysis was developed as a follow-up to this prior analysis, to evaluate the cost-consequence of using FLOSEAL vs SURGIFLO in major and severe spine surgery...
March 12, 2017: Journal of Medical Economics
Oktay Gurcan, Ahmet Gurhan Gurcay, Atilla Kazanci, Evrim Onder, Salim Senturk, Murad Bavbek
OBJECTIVE: Failed Back Syndrome (FBS) is unacceptable relief of pain or recurrence of symptoms in patients after spinal surgery, such as laminectomy. One possible cause of FBS is peridural fibrosis (PF). PF is the overproduction of scar tissue adjacent to the dura mater. Bleeding can cause PF after laminectomy. Ostene is an alkylene oxide copolymer material used to stop bleeding from bony surfaces. Floseal is a gelatin thrombin matrix sealant used to assist fibrin formation and to promote coagulation...
February 25, 2017: Acta Orthopaedica et Traumatologica Turcica
D Makhija, M Rock, Y Xiong, J D Epstein, M R Arnold, O M Lattouf, D Calcaterra
BACKGROUND: A recent retrospective comparative effectiveness study found that use of the FLOSEAL Hemostatic Matrix in cardiac surgery was associated with significantly lower risks of complications, blood transfusions, surgical revisions, and shorter length of surgery than use of SURGIFLO Hemostatic Matrix. These outcome improvements in cardiac surgery procedures may translate to economic savings for hospitals and payers. OBJECTIVE: The objective of this study was to estimate the cost-consequence of two flowable hemostatic matrices (FLOSEAL or SURGIFLO) in cardiac surgeries for US hospitals...
February 3, 2017: Journal of Medical Economics
James R Baylis, Andres Finkelstein-Kulka, Luis Macias-Valle, Jamil Manji, Michael Lee, Elina Levchenko, Christopher Okpaleke, Salahuddin Al-Salihi, Amin Javer, Christian J Kastrup
OBJECTIVES/HYPOTHESIS: Bleeding during endoscopic sinus surgery and open surgeries can easily obstruct the surgeons' field of view and increase morbidity and risk of intraoperative complications. Intraoperative bleeding could potentially be addressed by a hemostatic agent that safely disperses itself through the escaping blood. We tested the safety and efficacy of a self-propelling formulation of thrombin and tranexamic acid (SPTT) in stopping bleeding in a paranasal sinus injury and in an open surgical carotid injury sheep model...
April 2017: Laryngoscope
Brianne Bordes, David Martin, Brian Schloss, Allan Beebe, Walter Samora, Jan Klamar, David Stukus, Joseph D Tobias
When hemodynamic or respiratory instability occurs intraoperatively, the inciting event must be determined so that a therapeutic plan can be provided to ensure patient safety. Although generally uncommon, one cause of cardiorespiratory instability is anaphylactic reactions. During anesthetic care, these most commonly involve neuromuscular blocking agents, antibiotics, or latex. Floseal is a topical hemostatic agent that is frequently used during orthopedic surgical procedures to augment local coagulation function and limit intraoperative blood loss...
July 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Barrett R Park, Damon R Kuehl
We report a case of traumatic arterial hemorrhage from the posterior urethral artery, refractory to traditional hemostatic technique, and successfully managed with intraurethral thrombin hemostatic matrix (FloSeal [Baxter Healthcare Corporation, Deerfield, Illinois, US]). We believe that this demonstrates a safe, effective therapy for urethral hemorrhage that may be accomplished by Emergency Physicians and may preclude the need for more invasive hemorrhage control strategies.
September 3, 2016: Annals of Emergency Medicine
Julieta E Barroeta, Elliott Lhospital, Eugene Smith, Emily M Ko
We report the case of a 62-year-old woman who underwent laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection for endometrial endometrioid carcinoma FIGO grade 1. Cytologic examination of the pelvic washing specimen showed an acellular matrix with frayed edges and cracking artifact. Upon investigation, it became apparent that this could represent hemostatic matrix Floseal(R) that had been used intraoperatively at the lymphadenectomy site. Laboratory replication of the cytologic findings with a Floseal(R) sample confirmed it...
December 2016: Diagnostic Cytopathology
O C Wakelam, P A Dimitriadis, J Stephens
INTRODUCTION It is standard practice in the UK that if conservative measures or chemical cautery fail to control epistaxis, patients receive nasal packing which is often uncomfortable, requires admission and has well documented associated morbidity. Our study aims to evaluate the use of FloSeal haemostatic sealant in managing patients with epistaxis. MATERIALS AND METHODS Patients were identified from those referred with active epistaxis. A successful outcome was defined as complete haemostasis with FloSeal alone, with no further significant bleeding requiring admission or further interventions in the subsequent 7 days...
January 2017: Annals of the Royal College of Surgeons of England
Brian Y T Yue, Richard Zinn, Rachael Roberts, Jeremy Wilson
BACKGROUND: Haemostatic agents including thrombin-based haemostatic matrix are widely used in patients undergoing cardiac, vascular and spinal surgery. These agents promote local haemostasis through activation of the clotting cascade. To our knowledge, this case series is the first report of pulmonary embolization associated with FloSeal following head and neck oncology resection and free flap reconstruction. METHODS: We present five patients who were diagnosed with symptomatic pulmonary embolism after oncologic head and neck free flap reconstructions in 2014 and 2015...
August 3, 2016: ANZ Journal of Surgery
Felice Esposito, Paolo Cappabianca, Filippo F Angileri, Luigi M Cavallo, Stefano M Priola, Salvatore Crimi, Domenico Solari, Antonino F Germanò, Francesco Tomasello
OBJECTIVES: Gelatin-thrombin hemostatic matrix (FloSeal®) use is associated with shorter surgical times and less blood loss, parameters that are highly valued in neurosurgical procedures. We aimed to assess the effectiveness of gelatin-thrombin in neurosurgical procedures and estimate its economic value. PATIENTS AND METHODS: In a 6-month retrospective evaluation at 2 hospitals, intraoperative and postoperative information were collected from patients undergoing neurosurgical procedures where bleeding was controlled with gelatin-thrombin matrix or according to local bleeding control guidelines (control group)...
July 26, 2016: Journal of Neurosurgical Sciences
Yves Brand, Vairavan Narayanan, Narayanan Prepageran, Vicknes Waran
OBJECTIVE: To share our experience with a new delivery system for the flowable hemostatic matrix, FloSeal, in endoscopic and microscopic skull base surgery. METHODS: We prospectively analyzed the use of FloSeal with a hemostatic delivery system in transnasal endoscopic and microscopic skull base procedures performed at the authors' institution from January 1, 2015, to June 30, 2015. In all cases the number of aliquots was noted for the entire operation, and the total number of FloSeal ampules of 5 mL was also recorded...
June 2016: World Neurosurgery
Andrew S Lau, Navdeep S Upile, Lepa Lazarova, Andrew C Swift
Epistaxis is a common cause of emergency admissions in ENT. The use of Floseal haemostatic matrix in the treatment of epistaxis has been investigated in a number of studies in North America. We aimed to report a UK-based experience in the context of the current UK management paradigm. The study was designed as a prospective, unrandomised, control-matched longitudinal study. Cases were matched to controls in order to reduce the risk of bias. The overall treatment success rate for Floseal was 75 %, similar to the rates reported by studies based in North America...
September 2016: European Archives of Oto-rhino-laryngology
Idiris Altun
OBJECTIVE: To evaluate and compare the histopathologic effects of various hemostatic agents used in spinal surgery on an experimental laminectomy model in rats. METHODS: There were 110 rats randomly allocated into 11 groups, including sham, control, AnkaferdBlood Stopper (herbal hemostatic), SeraSeal (agar and bovine factor proteins), FLOSEAL (gelatin granules and thrombin), SURGIFLO (gelatin paste), HELITENE (absorbable collagen), Beriplast (fibrin sealant containing fibrinogen, factor XIII, and thrombin), TISSEEL (fibrin sealant), BLOODCARE (hemostatic powder), and SURGICEL (oxidized cellulose polymer) groups...
June 2016: World Neurosurgery
Eugenio Martorana, Ahmed Ghaith, Salvatore Micali, Giacomo Maria Pirola, Cosimo De Carne, Francesco Fidanza, Giampaolo Bianchi
BACKGROUND: Perioperative bleeding is a potential complication of robot-assisted laparoscopic radical prostatectomy (RALP) that may worsen outcomes. The role of local hemostatic materials in RALP has not been adequately assessed. We evaluated the hemostatic impact of FloSeal (Baxter International Inc., Fremont, Calif., USA) in RALP. METHODS: A retrospective analysis was performed of 392 consecutive patients with prostate cancer who underwent RALP at our institution between February 2008 and July 2014...
2016: Urologia Internationalis
Roberto Gazzeri
No abstract text is available yet for this article.
March 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Quan You Li, Osung Lee, Ho Sung Han, Gang-Un Kim, Chee Kean Lee, Sung Shik Kang, Myung Ho Lee, Hyeon Guk Cho, Ho-Joong Kim, Jin S Yeom
STUDY DESIGN: Retrospective fusion level(s)-, age-, and gender-matched analysis. PURPOSE: To determine whether the application of a topical gelatin-thrombin matrix sealant (Floseal) at the end of anterior cervical discectomy and fusion (ACDF) can reduce the amount of postoperative hemorrhage. OVERVIEW OF LITERATURE: The effect of the matrix sealant in decreasing postoperative hemorrhage following ACDF has not been reported. METHODS: Matrix sealant was (n=116, study group) or was not applied (n=58, control group) at the end of ACDF...
December 2015: Asian Spine Journal
Richard W Hutchinson, Stephanie Werrlein, Douglas B Johns, Gary Zhang, Jeffrey W Clymer, Richard Kocharian
Flowable gelatin matrix products have established themselves as effective, easy-to-use hemostatic agents useful in a variety of surgical situations. A recently reformulated gelatin matrix, Surgiflo® (Ethicon Inc., Somerville, NJ), can be prepared quickly and provides consistent flow over an 8-hr. period. No in vivo studies have yet been reported comparing hemostasis with the new Surgiflo to other currently marketed flowable gelatin matrix products. This study was conducted to determine whether Surgiflo in actual use has hemostatic qualities different from another commercial gelatin matrix...
November 2015: Surgical Technology International
Abdul Basit Karim, Sean Lindsey, Brian Bovino, Alejandro Berenstein
PURPOSE: This case series describes patients with head and neck arteriovenous malformations who underwent oral and maxillofacial surgical procedures combined with interventional radiology techniques to minimize blood loss. MATERIALS AND METHODS: Twelve patients underwent femoral cerebral angiography to visualize the extent of vascular malformation. Before the surgical procedures, surgical sites were devascularized by direct injection of hemostatic or embolic agents...
February 2016: Journal of Oral and Maxillofacial Surgery
P Faivre, S Laplante, H Kreuwel
No abstract text is available yet for this article.
November 2015: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Mehmet Ozgur Yucel, Haci Polat, Murat Bagcioglu, Tolga Karakan, Can Benlioglu, Ali Cift, Alper Gok, Hesna Muzeyyen Astarci, Turgay Akgul, Cankon Germiyanoglu
PURPOSE: The major complications of partial nephrectomy are bleeding and urine leakage. While various hemostatic agents are used to control bleeding, the histopathological characteristics of these hemostatic agents have not been investigated adequately. We aimed to investigate and compare the histopathological and hemostatic effects of local hemostatic agents in a partial nephrectomy rat model. METHODS: Thirty-two rats were divided into four equal groups, and partial nephrectomy was done to all rats...
January 2016: International Urology and Nephrology
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