Comparison of sternal intramedullary bleeding prevention strategies in cardiac surgery

Sternal intramedullary bleeding is an important contributor to postcardiac surgery hemorrhage. The aim of this study is to investigate the effects of bone wax, oxidized regenerated cellulose, and electrocoagulation on sternal intramedullary hemostatic control. Materials and methods: A total of 142 patients undergoing on-pump coronary bypass surgery were prospectively studied. The patients were randomized into 3 groups; bone wax concomitant with electrocauterization, oxidized regenerated cellulose concomitant with electrocauterization, and electrocauterization alone. The amount of postoperative hemorrhage was noted at the 1st, 2nd, 3rd, 6th, 12th and 24th hours. Rates of reexploration for hemorrhage and number of units of blood and its products used were also studied. Results: The mean age of the patients was 64.23 ± 5.81 years. There were 114 (79.7%) male patients. The patients were comparable regarding preoperative demographics except age and intraoperative variables. The amount of postoperative hemorrhage was lowest in the oxidized regenerated cellulose and highest in the electrocauterization alone group. The number of fresh frozen plasma and erythrocyte suspension used was also lowest in the oxidized regenerated cellulose group. Conclusion: To overcome hemorrhage originating from the sternal intramedullary space, oxidized regenerated cellulose use concomitant with electrocauterization is effective and can be safely used immediately before closing the chest in open heart surgery.

Comparison of sternal intramedullary bleeding prevention strategies in cardiac surgery

Sternal intramedullary bleeding is an important contributor to postcardiac surgery hemorrhage. The aim of this study is to investigate the effects of bone wax, oxidized regenerated cellulose, and electrocoagulation on sternal intramedullary hemostatic control. Materials and methods: A total of 142 patients undergoing on-pump coronary bypass surgery were prospectively studied. The patients were randomized into 3 groups; bone wax concomitant with electrocauterization, oxidized regenerated cellulose concomitant with electrocauterization, and electrocauterization alone. The amount of postoperative hemorrhage was noted at the 1st, 2nd, 3rd, 6th, 12th and 24th hours. Rates of reexploration for hemorrhage and number of units of blood and its products used were also studied. Results: The mean age of the patients was 64.23 ± 5.81 years. There were 114 (79.7%) male patients. The patients were comparable regarding preoperative demographics except age and intraoperative variables. The amount of postoperative hemorrhage was lowest in the oxidized regenerated cellulose and highest in the electrocauterization alone group. The number of fresh frozen plasma and erythrocyte suspension used was also lowest in the oxidized regenerated cellulose group. Conclusion: To overcome hemorrhage originating from the sternal intramedullary space, oxidized regenerated cellulose use concomitant with electrocauterization is effective and can be safely used immediately before closing the chest in open heart surgery.

___

  • Schonauer C, Tessitore E, Barbagallo G, Albanese V, Moraci A.
  • The use of local agents: bone wax, gelatin, collagen, oxidized
  • cellulose. Eur Spine J 2004; 13: S89–S96.
  • Masova L, Rysava J, Krizova P, Suttnar J, Salaj P, Dyr JE et al. Hemostyptic effect of oxidized cellulose on blood platelets. Sb Lek 2003; 104: 231–6.
  • Sabel M, Stummer W. The use of local agents: Surgicel and Surgifoam. Eur Spine J 2004; 13: S97–101.
  • Voormolen JH, Ringers J, Bots GT, van der Heide A, Hermans J. Hemostatic agents: brain tissue reaction and effectiveness. A comparative animal study using collagen fleece and oxidized cellulose. Neurosurgery 1987; 20: 702–9.
  • Wagner WR, Pachence JM, Ristich J, Johnson PC. Comparative in vitro analysis of topical hemostatic agents. J Surg Res 1996; 66: 100–8.
  • Spangler D, Rothenburger S, Nguyen K, Jampani H, Weiss S, Bhende S. In vitro antimicrobial activity of oxidized regenerated cellulose against antibiotic-resistant microorganisms. Surg Infect (Larchmt ) 2003; 4: 255–62.
  • Finn MD, Schow SR, Schneiderman ED. Osseous regeneration in the presence of four common hemostatic agents. J Oral Maxillofac Surg 1992; 50: 608–12.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Comparison of sternal intramedullary bleeding prevention strategies in cardiac surgery

Murat TAVLAŞOĞLU, Ahmet Barış DURUKAN, Mustafa KÜRKLÜOĞLU, Adem GÜLER

Prognostic factors in patients with glioblastoma multiforme (clinical research)

Mehmet Ali EKİCİ, Turgay BULUT, Bülent TUCER, Seyit Kaan BAŞARSLAN, Ali KURTSOY

Prevalence of type 1 diabetes mellitus in school children 6 18 years old in Diyarbakır, Southeastern Anatolian Region of Turkey

Hüseyin DEMİRBİLEK, Mehmet Nuri ÖZBEK

The effect of maternal–fetal attachment education on maternal mental health

Elieh ABASI, Mahin TAFAZZOLI, Habibolah ESMAILY, Hossain HASANABADI

Prevalence of carotid artery calcification on panoramic radiographs in patients with renal stones

İhsan ÜSTÜN, Mehmet İNCİ, Abdullah DEMİRTAŞ, Yıldıray ŞİŞMAN, Cumali GÖKÇE, Elif Tarim ERTAŞ

Variations of transverse foramens of cervical vertebrae: a 3-dimensional multidetector CT study

Bumin DEĞİRMENCİ, Ömer YILMAZ

Protective effect of vardenafil on ischemia reperfusion injury in rat ovary

Mustafa KARA, Hatice BAŞ, Dilek PANDIR, Özlem KARA

Prevalence of type 1 diabetes mellitus in school children 6–18 years old in Diyarbakır, Southeastern Anatolian Region of Turkey

Hüseyin DEMİRBİLEK, Mehmet Nuri ÖZBEK

The dose-dependent effect of grayanotoxin on the cardiovascular system

Süha TÜRKMEN, Ülkü KARAGÖZ, Abdulkadir GÜNDÜZ, Süleyman TÜREDİ, Metehan AKÇA, Mehmet YILDIRIM

Investigation of oxidative and antioxidative status in patients with diabetic cataracts

Nagihan UĞURLU, Fatma YÜLEK, Şule Berk ERGUN, Mehmet Doğan AŞIK, Semra IŞIKOĞLU, Emine AKÇAY