The use of haemostatic agents in thyroid surgery: efficacy and further advantages. Collagen-Fibrinogen-Thrombin Patch (CFTP) versus Cellulose Gauze.

AIM: To assess the efficacy of two widely used topical haemostatic agents: oxidised regenerated cellulose gauze and Collagen- Fibrinogen-Thrombin Patch in patients undergoing total thyroidectomy.

MATERIAL OF STUDY: This was a prospective, comparative, non-randomised study in which consecutive patients undergoing total thyroidectomy for benign disease received standard treatment with no haemostatic agent, cellulose gauze, or CFTP. Main outcome measures were drainage volume 24 hours after surgical procedure and the occurrence of post-operative complications (haematoma, seroma, surgical-site infection).

RESULTS: Two hundred seventy-one (271) patients undergoing total thyroidectomy for benign disease: 65 received standard treatment, 60 received cellulose gauze and 146 received CFTP. Seroma was significantly reduced in the CFTP group compared with both the cellulose gauze group (p=0.006) and the standard treatment group (p=0.017). A significant reduction in drainage volume was also observed with CFTP compared with the other two groups (both p<0.001). Drainage volume was also significantly reduced with cellulose gauze versus standard treatment (p<0.001). No septic events were observed after application of CFTP. One hematoma was observed in the non haemostatic group.

CONCLUSIONS: Both haemostatic agents reduced the amount of sero-hematic fluid during the first 24 hours post-surgery, with CFTP more effective than oxidized cellulose gauze. The use of haemostatic agents may increase the quality of thyroid surgery, improve patient comfort after surgery, and reduce hospital stay.