Objectives: a) Principal: To assess if the fibrin glue or the tranexamic acid reduce less than 20% the blood losses with respect to the habitual haemostasia in patients with arthroplasty total of knee. Secondaries: To assess the treatment safety. To perform a cost- analyses. Methods: Randomized, unicentric, and parallel clinical trial with four comparative groups: Tissucol® (fibrin glue), fibrin glue manufactured by the Cryoseal® system (Banc de Sang i Teixits de Catalunya), tranexamic acid and habitual haemostasia. Nº of participant centres: 1. Random allocation will be centralised. Main outcome: Blood losses (ml) in the post-operatory period collected by the habitual drain system. Secondary outcomes: Proportion of patients with blood transfusion, complications of surgery wound, pre and post-operative haemoglobin, units of blood transfused, post-operative mortality, days of hospital stay, safety of interventions assessed. Size sample calculation: The number needed of patients is 172 (43 per group) to demonstrate a 20% difference in the post-operative blood losses between the treatments assessed and the habitual haemostasia, with a statistical power of 80% and a 0.05 bilateral alpha, and a 20% of withdrawals. Statistical analysis: The investigators will perform a comparison of outcomes through the "t" test, the Mann-Whitney test of chi square, depending of the evaluated outcomes, quantitative or ordinals or qualitative, respectively. The software used will be Statistical Package for the Social Sciences (SPSS) version 17.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
172
Two dosage during the surgical intervention: the first dosage 15-30' before the leg ischemia and the second dosage at 60 -90' after the first dosage. Each dosage: 2 ampoules of 500mg/5 mL/ampoule
Topical administration, before to close the surgical wound. Dosage: 2 mL.
Topical administration, before to close the surgical wound.
The surgical habitual haemostasis.
Hospital de la Santa Creu i Sant Pau
Barcelona, Catalonia, Spain
Postoperative blood loss (mL)
Blood loss (mL) by the surgical wound collected by drain systems.
Time frame: During the first 48h after the surgical intervention
Percentage of patients that need a postoperative blood transfusion
Time frame: During the first postoperative week
Percentage of patients with surgical wound infection
Time frame: During the first postoperative month
Percentage of patients with surgical wound dehiscence
Time frame: During the first postoperative month
Percentage of patients with re-intervention by wound complications
Time frame: During the first postoperative month
Incidence of deep venous thrombosis
Time frame: During the first postoperative week
Pain of surgical wound
Time frame: During the first postoperative week
Units of blood transfusion
Time frame: During the first postoperative week
hospital length stay
Time frame: Days
Mortality
Time frame: During the first postoperative month
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