Abstract

BackgroundSurgical bleeding can be associated with an increased risk of morbidity and mortality across all surgical areas. Thus, numerous products have been developed to achieve haemostasis. A flowable haemostatic matrix such as Floseal® can quickly and reliably stop bleeding across the full spectrum of bleeding scenarios. The aim of this study was to systematically review clinical and economic evidence regarding the use of Floseal® in surgical procedures.MethodsAn extensive literature search was conducted in PubMed, EMBASE, and the Cochrane Library over the period spanning 2003–2013 to identify publications related to Floseal® use in all types of surgical procedures. Case reports and case series studies were excluded.ResultsA total of 27 papers met the selection criteria and were analysed. In the studies, blood loss and the time to achieve haemostasis were the most reported outcomes used to assess the efficacy of Floseal®. The majority of published studies (64%) examined the use of Floseal® compared with conventional methods (such as electrocautery or suturing). The remaining 36% of the studies evaluated the use of Floseal® compared with other haemostatic agents, such as Surgicel®, Gelfoam®, and Hemostase®. FloSeal® has been demonstrated to be an efficacious method in surgical procedures to reduce the time to achieve haemostasis, the frequency of intra- and postoperative bleeding, and the length of hospital stay, among other primary outcomes, resulting in less consumption of health resources.ConclusionsThe majority of the selected studies confirmed that Floseal® showed improvements over other haemostatic agents in achieving haemostasis and reducing blood loss.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2482-14-111) contains supplementary material, which is available to authorized users.

Highlights

  • Surgical bleeding can be associated with an increased risk of morbidity and mortality across all surgical areas

  • 372 publications were excluded for the following main reasons: studies comparing surgical procedures or examining products other than Floseal®, case reports, and in vitro and animal studies

  • The results showed that Floseal® use was associated with a lower risk of exceeding the expected length of hospital stay (LOS) compared with baseline

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Summary

Introduction

Surgical bleeding can be associated with an increased risk of morbidity and mortality across all surgical areas. The aim of this study was to systematically review clinical and economic evidence regarding the use of Floseal® in surgical procedures. The major surgical steps are incision, dissection, exposure, resection, haemostasis, restoring anatomy and closure. Only anatomy differs, but the challenges are always the same. The typical surgical challenges are bleeding, healing complications, leakage and adhesion formation. Addressing of these challenges, could impact on patient outcome such as haemorrhagic shock, blood replacement, longer hospital stay in case of bleeding. Can be associated with an increased risk of morbidity and mortality across all surgical areas. Bleeding complications arise in nearly 30% of surgeries [1]

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