A gelatin-thrombin matrix for hemostasis after endoscopic sinus surgery

Am J Otolaryngol. 2009 Jan-Feb;30(1):49-53. doi: 10.1016/j.amjoto.2007.11.008. Epub 2008 Jun 16.

Abstract

Purpose: Adequate hemostasis is necessary after endoscopic sinus surgery. This study evaluated the clinical performance of Surgiflo hemostatic matrix (Johnson&Johnson Wound Management, a division of Ethicon Inc, Somerville, NJ) with Thrombin-JMI (distributed by Jones Pharma Inc, Bristol, VA, a wholly owned subsidiary of King Pharmaceuticals, Bristol, TN) in achieving hemostasis in patients undergoing endoscopic sinus surgery. Surgiflo hemostatic matrix is a sterile, absorbable porcine gelatin intended to aid with hemostasis when applied to a bleeding surface.

Materials and methods: This multicenter, prospective, single-arm study evaluated the success in achieving hemostasis within 10 minutes of product application in patients undergoing elective primary or revision endoscopic sinus surgery for chronic sinusitis with a bleeding surface requiring hemostasis. Patient satisfaction and postoperative healing were also evaluated.

Results: Thirty patients were enrolled, including 17 males and 13 females (average age, 48.2 +/- 15.1 years), with 54 operated sides. Twenty-nine patients achieved hemostasis within 10 minutes of product application (96.7% success rate; 1-sided 95% confidence interval, 85.1%-100%). The median total time to hemostasis including manual compression was 61 seconds. No complications, such as synechiae, adhesion, or infection, were reported.

Conclusions: Surgiflo hemostatic matrix with Thrombin-JMI was clinically effective in controlling bleeding in 96.7% of patients. Further randomized controlled trials are indicated.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Loss, Surgical / prevention & control*
  • Endoscopy / methods*
  • Female
  • Follow-Up Studies
  • Hemostatics / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Paranasal Sinus Diseases / diagnosis
  • Paranasal Sinus Diseases / surgery*
  • Patient Satisfaction
  • Prospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Single-Blind Method
  • Thrombin / therapeutic use*
  • Time Factors
  • Treatment Outcome

Substances

  • Hemostatics
  • Thrombin