16870
document
Improved intraoperative management of anastomotic bleeding during aortic reconstruction : results of a randomized controlled trial . In a randomized controlled trial , the effectiveness of a polymeric surgical sealant ( CoSeal ) was compared to Gelfoam/thrombin for managing anastomotic bleeding after implantation of Dacron grafts during aortic reconstruction for nonruptured aneurysms . Each treatment was directly applied to the suture line after confirmation of anastomotic bleeding . The proportion of suture line sites that achieved immediate sealing and the proportion sealed within 5 minutes were determined among 37 experimental ( 59 sites ) and 17 control subjects ( 27 sites ) . A significantly greater proportion of bleeding suture line sites treated with the polymeric sealant achieved immediate sealing following reestablishment of blood flow compared with control-treated sites [ 48 of 59 ( 81 % ) vs 10 of 27 ( 37 % ) ; P = 0.002 ] . The difference between treatment groups was maintained after 5 minutes with approximately 85 per cent ( 50 of 59 ) of CoSeal sites compared to just over one-half ( 14 of 27 ) of control sites demonstrating ultimate sealing ( P = 0.01 ) . There were no adverse events related to the use of the polymeric sealant in this study . These results support the use of this novel sealant for the intraoperative management of anastomotic bleeding during aortic reconstruction procedures .
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Intervention_Surgical
polymeric surgical sealant ( CoSeal )
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Intervention_Physical
implantation
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Intervention_Surgical
Each treatment was directly applied to the suture line after confirmation of anastomotic bleeding .
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Intervention_Surgical
polymeric sealant
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Intervention_Surgical
CoSeal
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Intervention_Surgical
polymeric sealant
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Outcome_Other
Improved intraoperative management
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Outcome_Other
effectiveness
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Outcome_Physical
anastomotic bleeding
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Outcome_Other
immediate sealing
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Outcome_Other
immediate sealing
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Outcome_Physical
ultimate sealing
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Participant_Condition
anastomotic bleeding
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Participant_Condition
anastomotic bleeding
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Participant_Condition
nonruptured aneurysms
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Participant_Sample-size
37
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Participant_Sample-size
17
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Participant_Condition
anastomotic bleeding