Is the newest fibrin sealant an effective strategy to reduce blood loss after total knee arthroplasty? : a randomized controlled study

An RCT was conducted to ascertain whether, compared to control management, topical application of a novel fibrin sealant (Evicel, J&J) in patients undergoing primary TKA reduces peri-operative blood loss. Sixty-two patients were randomized to receive topical application of Evicel (N. = 31) or not (N. = 31). The mean total blood loss was 1.9. L(±. 0.7) in the control group and 1.8. L(±. 0.5) in the treatment group (P= 0.4). The transfusion rate was 32.3% in the control group and 25.8% in the treatment group (P= 0.5). The transfusion rate decreased linearly with increasing preoperative Hb levels in the treatment group (P= 0.005). The results of this study suggest that topical application of this novel fibrin sealant doesn't reduce perioperative blood loss and the need for allogeneic blood transfusion.