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 > or =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.