1. Does a kaolin-impregnated hemostatic dressing reduce intraoperative blood loss and blood transfusions in pediatric spinal deformity surgery?
- Author
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Abbott EM, Nandyala SV, and Schwend RM
- Subjects
- Adolescent, Blood Transfusion economics, Child, Cost Savings, Female, Hemostatics economics, Hospitals, Pediatric economics, Hospitals, Pediatric statistics & numerical data, Humans, Intraoperative Care economics, Intraoperative Care methods, Kansas, Male, Retrospective Studies, Scoliosis economics, Tertiary Care Centers economics, Tertiary Care Centers statistics & numerical data, Bandages economics, Blood Loss, Surgical prevention & control, Blood Transfusion statistics & numerical data, Hemostatic Techniques, Hemostatics administration & dosage, Kaolin, Scoliosis surgery, Spinal Fusion adverse effects, Spinal Fusion economics, Surgical Sponges economics
- Abstract
Study Design: Retrospective case-control study., Objective: To evaluate the hemostatic benefits of using a kaolin-impregnated dressing during pediatric spinal deformity correction surgery., Summary of Background Data: Minimizing blood loss and transfusions are clear benefits for patient safety. A technique common in both severe trauma and combat medicine that has not been reported in the spine literature is wound packing with a kaolin-impregnated hemostatic dressing., Methods: Estimated blood loss and transfusion amounts were analyzed in a total of 117 retrospectively identified cases. The control group included 65 patients (46 females, 19 males, 12.7±4.5 yr, 10.2±4.8 levels fused) who received standard operative care with gauze packing between June 2007 and March 2010. The treatment group included 52 patients (33 females, 19 males, 13.9±3.2 yr, 10.4±4.3 levels fused) who underwent intraoperative packing with QuikClot Trauma Pads (QCTP, Z-Medica Corporation) for all surgical procedures from July 2010 to August 2011. No other major changes in the use of antifibrinolytics or perioperative, surgical, or anesthesia technique were noted. Statistical differences were analyzed using analysis of covariance in R with P value of less than 0.05. The statistical model included sex, age, weight, scoliosis type, the number of vertebral levels fused, and surgery duration as covariates., Results: The treatment group had 40% less intraoperative estimated blood loss than the control group (974 mL vs. 1620 mL) (P<0.001). Patients who received the QCTP treatment also had 42% less total perioperative transfusion volume (499 mL vs. 862 mL) (P<0.01)., Conclusion: The use of a kaolin-impregnated intraoperative trauma pad seems to be an effective and inexpensive method to reduce intraoperative blood loss and transfusion volume in pediatric spinal deformity surgery., Level of Evidence: 3.
- Published
- 2014
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