Artikel
Application of fibrin glue for hematoma prophylaxis in selective aponeurectomy in Dupuytren's disease
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Veröffentlicht: | 6. Oktober 2022 |
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Gliederung
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Objectives: Fibrin glue (FG) can be applied in several surgical procedures at wound closure to reduce postoperative complications, like hematoma formation and wound impairment. The purpose of this study is to assess these preventive surgical benefits in Dupuytren's disease of the hand
Method: We performed a monocentric retrospective cohort study. All patients who underwent selective aponeurectomy for Dupuytren's disease between 2010 and 2020 were included. Patients were divided into two groups either receiving or not receiving FG. The primary outcome variables were the postoperative bleeding, wound healing impairment and the pooled postoperative complications
Results and Conclusion: 133 patients were included in the analysis of which 108 patients were treated with FG while 24 did not. There was no statistically significant difference in outcomes regarding postoperative bleeding, infections or revision surgery. However, in the group receiving FG, there was a tendency to higher wound healing impairment (13%, p=0.07). The FG group showed a significantly higher pooled complications' rate (18.5%, p<0.02). Complication in general increased with higher Tubiana classification and number of resected cords. Smoking tripled the risk of impaired wound, while cardiovascular comorbidities increased postoperative bleeding by the factor of 11
FG did not show a preventive outcome regarding bleeding. The FG group had a tendency for a higher wound healing incidence. Smoking and arterial hypertension correlated with a higher postoperative complication rate. The all-over incidence of complications was higher in the FG group. However, certain surgeons caused more complications despite using FG more frequently. The quality of the surgical intervention as well as accurate hemostasis cannot be corrected by the application of FG