Effect of the Mixture of Thrombin Powder and Gelfoam Powder on Control of Exposed Cancellous Bone Bleeding

Thrombin Powder와 Gelfoam Powder의 혼합물을 이용한 노출된 망상골면 출혈의 지혈효과

  • Park, Sung Wan (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Cho, Ha Young (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Lee, Seung Myoung (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Jeong, Seong Hun (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Song, Jin Kyu (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Jang, Suk Jung (Department of Neurosurgery, College of Medicine, Chosun University) ;
  • Shin, Ho (Department of Neurosurgery, College of Medicine, Chosun University)
  • 박성완 (조선대학교 의과대학 신경외과학교실) ;
  • 조하영 (조선대학교 의과대학 신경외과학교실) ;
  • 이승명 (조선대학교 의과대학 신경외과학교실) ;
  • 정성헌 (조선대학교 의과대학 신경외과학교실) ;
  • 송진규 (조선대학교 의과대학 신경외과학교실) ;
  • 장석정 (조선대학교 의과대학 신경외과학교실) ;
  • 신호 (조선대학교 의과대학 신경외과학교실)
  • Received : 1999.09.21
  • Accepted : 1999.11.24
  • Published : 2000.05.28

Abstract

Objective : Excessive bleeding from the exposed cancellous bone surface may cause serious problem such as hematoma formation, infection, transfusion reaction during operation and postoperative period. There are several kinds of bleeding control agent on the cancellous bone surface including bone wax, gelatin sponge ($Gelfoam^{(R)}$), oxidized cellulose($Oxycel^{(R)}$, $Surgicel^{(R)}$), thrombin, microfibrillar collagen($Avitene^{(R)}$) etc. In the past, bone wax was used to control bone bleeding but it is associated with increased infection rate and fusion failure. Recently, gelfoam paste has been used to control cancellous bone bleeding. We controlled the cancellous bone bleeding with the mixture of gelfoam powder and thrombin powder. Material and Methods : Seventeen patients of posterior fusion on the 4 motion segments of thoracolumbar spine were selected to compare the result of bone bleeding control. In the test group of 9 patients, the cancellous bone bleeding was controlled with the mixture of Gelfoam and thrombin powder during operation. In the control group of 8 cases, no chemical hemostatic agent was used to manage the bone bleeding during operation. We calculated the total amount of bleeding from cancellous bone surface during and after operation in the two groups and compared their statistic significance of the result which was judged by student t-test. Results : The average amount of intraoperative bleeding was 1825ml in control group, 811ml in test group(p<0.01). The amount of postoperative bleeding was 943ml in control group and 812ml in test group, there were no significant difference in the amount of bleeding during postoperative period between two groups(p>0.5). Total amount of blood was decreased in as much as 1150ml in test group(p<0.01). Conclusion : We concluded that the application of the mixture of thrombin and gelfoam powder on the cancellous bone surface is the effective control method of cancellous bone bleeding for multilevel posterior spinal fusion.

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