Faculty Collaboration Database

The effect of TISSEEL fibrin sealant on seroma formation following complex abdominal wall hernia repair: a single institutional review and derived cost analysis. Hernia 2015 Dec;19(6):935-42

Date

07/15/2015

Pubmed ID

26152522

DOI

10.1007/s10029-015-1403-4

Scopus ID

2-s2.0-84948381529 (requires institutional sign-in at Scopus site)   24 Citations

Abstract

PURPOSE: The authors evaluated the ability of a fibrin sealant (TISSEEL™: Baxter Healthcare Corp, Deerfield, IL, USA) to reduce the incidence of post-operative seroma following abdominal wall hernia repair.

METHODS: We performed a 4-year retrospective review of patients undergoing abdominal wall hernia repair, with and without TISSEEL, by a single surgeon (FEE) at The Johns Hopkins Hospital. Demographics, surgical risk factors, operative data and 30-day outcomes, including wound complications and related interventions, were compared. The quantity and cost of Tisseel per case was reviewed.

RESULTS: A total of 250 patients were evaluated: 127 in the TISSEEL group and 123 in the non-TISSEEL control group. The average age for both groups was 56.6 years (P = 0.97). The majority of patients were female (TISSEEL 52.8%, non-TISSEEL 56.1%, P = 0.59) and ASA Class III (TISSEEL 56.7%, non-TISSEEL 58.5%, P = 0.40). There was no difference in the average defect size for both groups (TISSEEL 217 ± 187.6 cm(2), non-TISSEEL 161.3 ± 141.5 cm(2), P = 0.36). Surgical site occurrences occurred in 18.1% of the TISSEEL and 13% of the non-TISSEEL group (P = 0.27). There was a trend towards an increased incidence of seroma in the TISSEEL group (TISSEEL 11%, non-TISSEEL 4.9%, P = 0.07). A total of $124,472.50 was spent on TISSEEL, at an average cost of $995.78 per case.

CONCLUSIONS: In the largest study to date, TISSEEL™ application offered no advantage for the reduction of post-operative seroma formation following complex abdominal hernia repair. Moreover, the use of this sealant was associated with significant costs.

Author List

Azoury SC, Rodriguez-Unda N, Soares KC, Hicks CW, Baltodano PA, Poruk KE, Hu QL, Cooney CM, Cornell P, Burce K, Eckhauser FE

Author

Nelson Agustin Rodriguez-Unda MD Assistant Professor in the Plastic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Abdominal Wall
Adult
Aged
Costs and Cost Analysis
Female
Fibrin Tissue Adhesive
Hernia, Ventral
Herniorrhaphy
Humans
Male
Middle Aged
Retrospective Studies
Seroma
Wound Healing