Reducing blood loss at myomectomy with use of a gelatin-thrombin matrix hemostatic sealant

Objective To evaluate the hemostatic efficacy and handling of gelatin-thrombin matrix in abdominal myomectomy. Design Prospective and randomized trial. Setting University teaching hospital. Patient(s) Women (n = 50) with uterine fibroids with a uterine size equivalent to ≥16 weeks gestation. Intervention(s) Gelatin-thrombin matrix (FloSeal Matrix; Baxter Healthcare Corp., Fremont, CA) was delivered to the site of the uterine bleeding during myomectomy. Main Outcome Measure(s) Patient age, parity, number of myomas, operative time, blood loss, transfusion, intraoperative and postoperative complications, and length of hospitalization were evaluated. Result(s) The average blood loss during surgery was 80 ± 25.5 mL for the FloSeal group and 625 ± 120.5 mL for the control group. Intraoperative blood transfusion was necessary in five patients from the control group. Postoperative blood loss was 25 ± 5 mL for the FloSeal group and 250 ± 75 mL for the control group. Length of the postoperative hospital stay was 2.5 ± 1.2 days for FloSeal group and 4.5 ± 1.3 for the control group. No major immediate or delayed complications were observed in either group. Conclusion(s) Reductions in hemorrhage in FloSeal-treated women undergoing a myomectomy are encouraging, and provide evidence for the ability of gelatin-thrombin matrix to reduce blood loss when applied immediately and directly to bleeding uterine tissue.