caa a22 4500 605457328 CHVBK 20210128100222.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00167-014-2898-4 doi (NATIONALLICENCE)springer-10.1007/s00167-014-2898-4 Fibrin sealant before wound closure in total knee arthroplasty reduced blood loss: a meta-analysis [Elektronische Daten] [Zhi-jun Li, Xin Fu, Peng Tian, Wen-xing Liu, Yao-min Li, Yong-fa Zheng, Xin-long Ma, Wei-min Deng] Purpose: Fibrin sealant (FS) comprises a mixture of fibrinogen and thrombin that controls bleeding, reduces blood transfusions, improves tissue healing and shortens postoperative recovery time after various surgical procedures. However, no single study has been large enough to definitively determine whether fibrin sealant is safe and effective. We report a meta-analysis of randomized controlled trials (RCTs) evaluating the efficacy and safety of fibrin sealant in total knee arthroplasty. Methods: Articles published before August, 2012 were identified from PubMed, Embase, The Cochrane Library and other internet databases. Relevant journals and the recommendations of expert panels were also searched manually. We included only high-quality RCTs. Two independent reviewers searched and assessed the literature. Relevant data were analysed using RevMan 5.0. Results: Seven RCTs met the inclusion criteria. Use of fibrin sealant significantly reduced haemoglobin decline mean difference (MD=−0.72), 95% confidence interval [95% CI (−0.83, −0.62), p<0.00001], postoperative drainage volume [MD=−354.53, 95% CI (−482.43, −226.63), p<0.00001], the proportion of patients requiring blood transfusion risk differences [RD=−0.27, 95% CI (−0.45, −0.08), p=0.006] and the incidence of wound haematoma [RD=−0.11, 95% CI (−0.22, −0.00), p=0.04]. There were no significant differences in deep vein thrombosis, pulmonary embolism, infection rate or other complications between groups. Conclusions: Use of fibrin sealant in total knee arthroplasty was effective and safe, reduced haemoglobin decline, postoperative drainage volume, incidence of haematoma and need for blood transfusion, and did not increase the risk of complications. Due to the limited quality of the evidence currently available, more high-quality RCTs are required. Level of evidence: II. Springer-Verlag Berlin Heidelberg, 2014 Fibrin sealant nationallicence Knee nationallicence Arthoplasty nationallicence Meta-analysis nationallicence Blood loss nationallicence Li Zhi-jun Department of Orthopedics, Tianjin Medical University General Hospital, 300054, Tianjin, People's Republic of China aut Fu Xin Department of Orthopedics, Tianjin Hospital, 300211, Tianjin, People's Republic of China aut Tian Peng Department of Orthopedics, Tianjin Hospital, 300211, Tianjin, People's Republic of China aut Liu Wen-xing Department of Immunology, Tianjin Medical University, 300070, Tianjin, People's Republic of China aut Li Yao-min Department of Rehabilitation, Tianjin Hospital, 300211, Tianjin, People's Republic of China aut Zheng Yong-fa Department of Orthopedics, Tianjin Medical University General Hospital, 300054, Tianjin, People's Republic of China aut Ma Xin-long Department of Orthopedics, Tianjin Medical University General Hospital, 300054, Tianjin, People's Republic of China aut Deng Wei-min Department of Immunology, Tianjin Medical University, 300070, Tianjin, People's Republic of China aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/7(2015-07-01), 2019-2025 0942-2056 23:7<2019 2015 23 167 https://doi.org/10.1007/s00167-014-2898-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 review-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-2898-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Li Zhi-jun Department of Orthopedics, Tianjin Medical University General Hospital, 300054, Tianjin, People's Republic of China aut NATIONALLICENCE 700 1- Fu Xin Department of Orthopedics, Tianjin Hospital, 300211, Tianjin, People's Republic of China aut NATIONALLICENCE 700 1- Tian Peng Department of Orthopedics, Tianjin Hospital, 300211, Tianjin, People's Republic of China aut NATIONALLICENCE 700 1- Liu Wen-xing Department of Immunology, Tianjin Medical University, 300070, Tianjin, People's Republic of China aut NATIONALLICENCE 700 1- Li Yao-min Department of Rehabilitation, Tianjin Hospital, 300211, Tianjin, People's Republic of China aut NATIONALLICENCE 700 1- Zheng Yong-fa Department of Orthopedics, Tianjin Medical University General Hospital, 300054, Tianjin, People's Republic of China aut NATIONALLICENCE 700 1- Ma Xin-long Department of Orthopedics, Tianjin Medical University General Hospital, 300054, Tianjin, People's Republic of China aut NATIONALLICENCE 700 1- Deng Wei-min Department of Immunology, Tianjin Medical University, 300070, Tianjin, People's Republic of China aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/7(2015-07-01), 2019-2025 0942-2056 23:7<2019 2015 23 167