Fibrin tissue adhesive reduces postoperative blood loss in total knee arthroplasty.

The topic of applying fibrin glue for reducing perioperative blood loss has been overexamined, with rather contradictory results. The authors report the results of a well conducted, randomized, prospective study. The number of patients included is relatively small but all operations were performed by the same surgeon and the conclusions are quite clear. A statistically significant reduction in total blood loss was observed but, curiously, no reduction in blood trasfusion requirements. Although 66% of patients of the control group received exclusively autologous, postoperatively recovered blood, the authors correctly claim that prevention of blood loss, including prevention of concomitant compartmental shift in body fluid, is definitely superior to the replacement of lost blood!

– Constantine Vagianos