A prospective, randomized, controlled trial of the efficacy and safety of fibrin pad as an adjunct to control soft tissue bleeding during abdominal, retroperitoneal, pelvic, and thoracic surgery.

Fischer CP, Bochicchio G, Shen J, Patel B, Batiller J, Hart JC
J Am Coll Surg 2013;217:385-393.
NATA Rating :
Review by : C. Vagianos
NATA Review

This interesting article compares the hemostatic efficacy of a fibrin pad and the well-known “Surgicel”. Although not blinded, this is a well-conducted prospective study examining the effects of these hemostatic agents in mild and moderate bleeding. A significant benefit was shown in favor of the fibrin pad in permanently controlling bleeding. Consequently, the authors give a clear message that fibrin pad should be preferred to Surgicel.

However, as many more hemostatic agents are in use, a similar question may arise for each of them. Additionally, a critical point in order to positively assess the usefulness of the fibrin pad is its cost, and this is not mentioned, representing a significant drawback of the study. Finally, we should always keep in mind that mild and moderate bleeding can be easily controlled by faster, simpler and cheaper techniques, such as pressure, coagulation or suturing, making hemostats of any kind unnecessary in most cases!

– Constantine Vagianos