Fibrin sealant provides superior hemostasis for sternotomy compared with bone wax.

Abstract

The purpose of this study was to evaluate the hemostatic efficacy and feasibility of direct injection of fibrin sealant into the sternal marrow cavity in senior patients undergoing on-pump coronary artery bypass grafting (CABG). A total of 82 senior patients undergoing on-pump CABG were randomized to the bone wax group (n=40) or the fibrin sealant group (n=42) for the period July 2010 to January 2011. The fibrin sealant-treated group had less chest drainage in the first 24 hours (186.67±49.53 versus 333.75±60.49 mL), less total chest drainage (326.19±67.24 versus 516±88.46 mL), less packed red blood cell (PRBC) administration (3.6±1.25 versus 7.4±2.13 U), less fresh frozen plasma (FFP) administration (5.52±1.64 versus 8.95±1.77 U), shorter intubation time (40.36±8.62 versus 46.25±10.46 hours), and shorter hospital stay (10.45±1.17 versus 11.03±1.37 days) compared with the bone wax group. No significant difference in the incidence of postoperative complications was found. Direct injection of fibrin sealant into the sternal marrow cavity significantly reduces the amount of postoperative blood loss and offers an attractive new treatment alternative for senior patients undergoing on-pump CABG.