Hemostatic effect of fibrin glue for sternal marrow bleeding.

흉골 출혈에 대한 fibrin glue의 지혈 효과

Bleeding from bone marrow after sternotomy for open cardiac surgery can be sometimes difficult to control and even lead to reoperation for hemostasis. A clinical comparative study was carried out to demonstrate the hemostatic effect of fibrin glue [Beriplast] for sternal marrow bleeding after sternotomy for open heart surgery. Postoperative blood loss was measured in two patient groups, group A included 19 patients operated upon from June to October 1987 and the fibrin glue was applied to the sternal marrow together with collagen fleece and group B consisted of 22 patients from January to May 1987 and only collagen fleece was applied without fibrin glue. There was no difference between two groups in age and sex distributions, coagulation state, method of extracorporeal circulation and operative management. The blood loss one hour after operation was 2.04 ml/hr/kg in group A and 3.55 ml/hr/kg in group B [P<0.001]. The most significant difference was observed during the first 4 hours after surgery with 1.34 ml/hr/kg versus 2.05 ml/hr/kg. over the following 20 hours the amount of drainage from the chest tubes was identical in both groups. Fibrin glue reduces blood loss after open heart surgery by local hemostasis at sternum. Our study has shown that local application of fibrin glue to sternal marrow is an effective method of controlling the sternal bleedings. No side effect or complication of fibrin glue was noted.