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Effectiveness of an oxidized cellulose patch hemostatic agent in thyroid surgery: a prospective, randomized,
Moran Amit1, Yoav Binenbaum, Jacob T Cohen
1Department of Otolaryngology Head and Neck Surgery, Rambam Medical Center, the Technion, Israel Institute of Technology, Haifa, Israel.
Journal of the American College of Surgeons
|July 23, 2013
Summary
In thyroid surgery, an oxidized cellulose patch (Surgicel) showed no benefit over conventional hemostasis. Conventional methods led to shorter hospital stays and quicker drain removal, suggesting Surgicel may be potentially harmful.
Area of Science:
- Endocrinology
- Surgical Innovation
- Hemostasis Techniques
Background:
- Thyroid surgery necessitates effective hemostasis to minimize complications.
- Oxidized cellulose patches are utilized for hemostasis, but their efficacy in thyroid surgery requires evaluation.
Purpose of the Study:
- To compare the efficacy and safety of an oxidized cellulose patch (Surgicel) versus conventional hemostasis in thyroid surgery.
Main Methods:
- A single-blinded, prospective, randomized controlled trial involving 190 patients undergoing thyroidectomy.
- Patients were randomized into two groups: conventional hemostasis (ligatures, electrocautery) or conventional hemostasis plus Surgicel.
- Outcomes assessed included bleeding rates, wound complications, and length of hospital stay.
Main Results:
- While postoperative bleeding was higher in the Surgicel group, the difference was not statistically significant (p=0.054).
- No significant differences were observed in wound infection, seroma, hypocalcemia, or recurrent laryngeal nerve palsy between groups.
- Conventional hemostasis resulted in significantly shorter times for drain removal and hospital stay (p < 0.001).
Conclusions:
- Routine use of oxidized cellulose hemostatic agents offers no advantage in thyroid surgery.
- The use of Surgicel in thyroid surgery may be associated with potential harm and does not improve patient outcomes.
- Conventional hemostasis techniques remain superior for thyroid surgery regarding recovery time.