Effect of Human Thrombin With Gelatin Matrix on Perioperative Blood Loss in Scoliosis Surgery
Recruitment status was: Recruiting
|Adolescent Idiopathic Scoliosis||Device: Gelatin matrix with human derived thrombin (Floseal, Baxter)||Phase 4|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Participant)
Primary Purpose: Treatment
|Official Title:||Effectiveness Of Gelatin Matrix With Human Derived Thrombin On Blood Loss, Surgical Time, Hospital Stay And Complications In Adolescents Undergoing Spine Surgery For Adolescent Idiopathic Scoliosis: A Randomized Clinical Trial.|
- Total perioperative blood loss [ Time Frame: Surgery time (up to 8 hours) + first postoperative 24 hours ]Total blood loss during surgery + drain output, millilitres
- Used blood products [ Time Frame: Surgery time (up to 8 hours) + first 24 hours postoperatively ]Red cell, frozen plasma, and thrombocyte units
- Blood loss during surgery [ Time Frame: up to 8 hours ]Blood loss during primary surgery, in millilitres
- Time of surgery [ Time Frame: up to 8 hours ]Time of surgery (hours, minutes)
|Study Start Date:||November 2011|
|Estimated Study Completion Date:||December 2016|
|Estimated Primary Completion Date:||December 2014 (Final data collection date for primary outcome measure)|
No Intervention: Conventional group
conventional blood saving methods (use of bone wax for cancellous bony bleeding; bipolar diathermy and epidural space packing for epidural venous bleeding)
Gelatin matrix with human derived thrombin (Floseal) used in adolescents undergoing posterior spinal deformity surgery for adolescent idiopathic scoliosis (AIS)
Device: Gelatin matrix with human derived thrombin (Floseal, Baxter)
Floseal will be used to stop cancellous bone bleeding, pedicle channel bleeding or epidural space bleeding by injecting suitable amount of this matrix and irrigating it away after few minutes.
Other Name: Floseal, Baxter
Background: Posterior spinal deformity surgery can be associated with major blood loss, especially from cancellous bone or epidural venous plexus. Products such as Gelatin Matrix with bovine derived thrombin (Floseal) can be used to prevent blood loss in adult patients undergoing spine surgery.
Aim: To document and compare effectiveness of Gelatin matrix with human derived thrombin with conventional blood loss control methods in adolescents undergoing posterior spinal deformity surgery for adolescent idiopathic scoliosis (AIS), who do not need vertebral column resection.
Methods: The Finnish Paediatric Orthopaedic Study Group will perform a prospective randomized, multicenter, clinical trial comparing Gelatin matrix with human derived thrombin (Floseal, Baxter) and without use of Floseal in adolescents undergoing posterior spinal deformity surgery for AIS (adolescent idiopathic scoliosis between 45 and 90 degrees) in Turku, Tampere and Helsinki Children's Hospitals. Sixty patients will be randomized into the intervention group receiving Floseal (n=30) and control group not receiving Floseal (n=30). Each University Hospital will treat 10 Floseal and 10 conventional treated scoliosis patients (block randomization). Both treatment groups will be allowed to use conventional blood saving methods.
Main outcome measures:
Blood loss during surgery (millilitres) Drain output during 24 hours (millilitres) Total blood loss (Blood loss during surgery + drain output, millitres) Used blood products (Red cell, frozen plasma, and thrombocyte units) Time of surgery Hospital stay Cost benefit analysis (blood product use, surgical time, hospital stay) Complications related to use of Floseal as a secondary outcome measure.
Primary Hypothesis and expected outcomes: Use of Floseal will reduce blood loss and surgical time in patients undergoing spine surgery for adolescent idiopathic scoliosis (Level-I evidence). Cost benefit analysis will most probably show that the use of Floseal is cost effective. E.g. the value of one allogenic Red Blood Cell unit is 400€. If no red blood cell units are needed instead of the usual three, the reduced blood product use alone will cover the extra costs of Floseal use. In addition, if no allogenic blood infusions are needed, the risk of infections will probably be significantly less. Reduced surgical time and shorter hospital stay may also be cost reducing findings in patients receiving Floseal.
Safety Aspects: Gelatin Matrix with human derived thrombin (Floseal, Baxter Biosurgery) is indicated for blood loss control in patients undergoing spine surgery when other methods are less effective.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01451788
|Contact: Ilkka J. Helenius, M.D., Ph.D.||+firstname.lastname@example.org|
|Contact: Olli T. Pajulo, M.D., Ph.D.||+email@example.com|
|Helsinki University Central Hospital||Recruiting|
|Contact: Mikko Mattila, MD +358-9-4711 firstname.lastname@example.org|
|Principal Investigator: Mikko Mattila, MD|
|Tampere University Central Hospital||Recruiting|
|Contact: Jarmo Valipakka, MD email@example.com|
|Contact: Tuija Lahdes-Vasama, MD, PhD firstname.lastname@example.org|
|Principal Investigator: Jarmo Valipakka, MD|
|Turku Children's Hospital||Recruiting|
|Turku, Finland, FI-20521|
|Contact: Ilkka J. Helenius, MD, PhD +358-2-3130218 email@example.com|
|Contact: Olli T. Pajulo, MD, PhD +358-2+3130000 firstname.lastname@example.org|
|Sub-Investigator: Olli Pajulo, MD, PhD|
|Principal Investigator: Ilkka Helenius, MD, PhD|
|Study Director:||Ilkka J. Helenius, M.D., Ph.D.||Turku Children's Hospital, Turku University Central Hospital|