Use of a Thrombin Fibrin Sealant in Reducing Blood Loss in Revision Hip Arthroplasty

We present a retrospective evaluation assessing the use of a novel fibrin sealant, Quixil(®) (OMRIX Biopharmaceuticals S.A.) in reducing blood transfusions following revision total hip replacement surgery. Forty four patients underwent revision total hip replacement surgery using Quixil(®), while 45 patients underwent revision total hip replacement surgery without the use of Quixil(®). The duration of surgery and patient demographics were similar in both groups. Average blood loss was 1,010ml in the Quixil(®) group versus 1,021ml in the non-Quixil group. The use of cell saver and intra-operative blood transfusion were similar in both groups. The mean pre-operative Haemoglobin was 13.0 g/dl in the Quixil(®) group versus 12.4 g/dl in the non-Quixil group. The mean post-operative haemoglobin was 10.2 g/dl and 9.1 g/dl in the Quixil(®) and non-Quixil groups respectively. There was no difference in the blood transfused post-operatively between the two groups. Total units of blood transfused in Quixil(®) versus non-Quixil group were 60 verus 86. Total units of intra-operative blood transfused in Quixil(®) versus non-Quixil group were 16 versus 23. The use of fibrin tissue adhesive in revision total hip arthroplasty seems to be an effective and reliable means to reduce blood-transfusion requirements and prevent post-operative decreases in hemoglobin.