슬관절 전치환술 후 출혈에 대한 Fibrin Glue의 효과 = Fibrin Glue for Bleeding after Total Knee Arthroplasty

다국어 초록 (Multilingual Abstract)

Total knee arthroplasty has been associated with marked blood loss despite the use of a
tourniquet and minimal postoperative suction drainage. The purpose of this study was to
determine the effect and complication of topically applied fibrin glue(Tisseel) on blood
loss. Fibrin glue was used to coat the operative site with a fibrin clot to determine the
effect on postoperative blood loss. We reviewed 71 cemented total knee arthroplasties
from June, 1996 to April, 1998. 71 cases of the total knee arthroplasty was composed of
31 case without fibrin glue(Group I), 12 cases with 5cc fibim glue(Group II) and 28
cases with 10cc fibrin glue(Group III). Hemoglobin and hematocrit were assayed before
surgery and 1 day after surgery, and we compared the amount of the total blood loss,
autotransfusion in each groups. The average amount of total blood loss is
1362cc(775-2150) in group I,1164cc(505-1670) in Group II, 772 cc(380-1410) in Group III.
The average amount of autotransfusion is 72.7%(990cc) of total blood loss in group I,
91.4%(1064cc) in group II, 90%(650cc) in Group III, and Group II & III can autotransfuse
above 90% of total blood loss. No significant difference was noted in preoperative and
postoperative hemoglobin and hematocrit between each groups. Administration of fibrin
glue gives a significant reduction of blood loss, enables autotransfusion about 90% of
total blood loss, and provide the advantages of safety from transmission of viral
diseases and from immunologic reaction. In conclusion, fibrin glue is a safe and effective
hemostatic agent for bleeding control after cemented total knee arthroplasty.