Abstract
OBJECTIVE: To assess the efficacy of two measures for the control of postoperative haemorrhage in patients with fibrothoracic disease secondary to symptomatic extraparenchymal restrictive disease (e.g. empyema, haematoma) undergoing decortication. METHODS: This randomized, prospective study was performed in 50 adult patients with fibrothoracic disease secondary to symptomatic extraparenchymal restrictive disease who were scheduled to undergo decortication. Patients were randomized to receive either electrocautery plus hot compressor application or a thrombin-added haemostatic matrix (THM) for intraoperative haemostasis (n = 25 per group). Control of postoperative haemorrhage was compared between groups by evaluation of pre- and postoperative blood characteristics and mean postoperative drainage volume and blood transfusion requirements. RESULTS: Mean postoperative drainage and blood transfusion volumes were significantly lower in the THM group versus the electrocautery plus hot compress group. There was no difference in preoperative and postoperative blood tests in the THM group, whereas significant differences were observed in the electrocautery plus hot compress group. There were no infections, systemic allergies or sensitization, or reoperations in either group. CONCLUSIONS: Compared with electrocautery plus hot compress, the use of a THM significantly reduced postoperative haemorrhage and blood transfusion requirements in patients who underwent decortication.