Kaolin-based Hemostatic Gauze in Total Knee Arthroplasty

Summary

This study is to conduct a prospective randomized controlled trial to investigate the blood-conservation effect of combination of intravenous TXA and QCG in a primary TKA procedure.

Timeline

Start

2022-03-16

Primary completion

2023-07-31

Completion

2023-07-31

Publications

• Background Bong MR, Patel V, Chang E, Issack PS, Hebert R, Di Cesare PE. Risks associated with blood transfusion after total knee arthroplasty. J Arthroplasty. 2004 Apr;19(3):281-7. doi: 10.1016/j.arth.2003.10.013.
• Background Bierbaum BE, Callaghan JJ, Galante JO, Rubash HE, Tooms RE, Welch RB. An analysis of blood management in patients having a total hip or knee arthroplasty. J Bone Joint Surg Am. 1999 Jan;81(1):2-10. doi: 10.2106/00004623-199901000-00002.
• Background Goodnough LT, Verbrugge D, Marcus RE. The relationship between hematocrit, blood lost, and blood transfused in total knee replacement. Implications for postoperative blood salvage and reinfusion. Am J Knee Surg. 1995 Summer;8(3):83-7.
• Background Tanaka N, Sakahashi H, Sato E, Hirose K, Ishima T, Ishii S. Timing of the administration of tranexamic acid for maximum reduction in blood loss in arthroplasty of the knee. J Bone Joint Surg Br. 2001 Jul;83(5):702-5. doi: 10.1302/0301-620x.83b5.11745.
• Background Alvarez JC, Santiveri FX, Ramos I, Vela E, Puig L, Escolano F. Tranexamic acid reduces blood transfusion in total knee arthroplasty even when a blood conservation program is applied. Transfusion. 2008 Mar;48(3):519-25. doi: 10.1111/j.1537-2995.2007.01564.x. Epub 2007 Dec 7.
• Background Petaja J, Myllynen P, Myllyla G, Vahtera E. Fibrinolysis after application of a pneumatic tourniquet. Acta Chir Scand. 1987 Nov-Dec;153(11-12):647-51.
• Background Kambayashi J, Sakon M, Yokota M, Shiba E, Kawasaki T, Mori T. Activation of coagulation and fibrinolysis during surgery, analyzed by molecular markers. Thromb Res. 1990 Oct 15;60(2):157-67. doi: 10.1016/0049-3848(90)90294-m.
• Background Hiippala S, Strid L, Wennerstrand M, Arvela V, Mantyla S, Ylinen J, Niemela H. Tranexamic acid (Cyklokapron) reduces perioperative blood loss associated with total knee arthroplasty. Br J Anaesth. 1995 May;74(5):534-7. doi: 10.1093/bja/74.5.534.
• Background Benoni G, Fredin H. Fibrinolytic inhibition with tranexamic acid reduces blood loss and blood transfusion after knee arthroplasty: a prospective, randomised, double-blind study of 86 patients. J Bone Joint Surg Br. 1996 May;78(3):434-40.
• Background Lin PC, Hsu CH, Chen WS, Wang JW. Does tranexamic acid save blood in minimally invasive total knee arthroplasty? Clin Orthop Relat Res. 2011 Jul;469(7):1995-2002. doi: 10.1007/s11999-011-1789-y. Epub 2011 Feb 1.
• Background Wong J, Abrishami A, El Beheiry H, Mahomed NN, Roderick Davey J, Gandhi R, Syed KA, Muhammad Ovais Hasan S, De Silva Y, Chung F. Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty: a randomized, controlled trial. J Bone Joint Surg Am. 2010 Nov 3;92(15):2503-13. doi: 10.2106/JBJS.I.01518.
• Background Wind TC, Barfield WR, Moskal JT. The effect of tranexamic acid on blood loss and transfusion rate in primary total knee arthroplasty. J Arthroplasty. 2013 Aug;28(7):1080-3. doi: 10.1016/j.arth.2012.11.016. Epub 2013 Mar 28.
• Background Chimento GF, Huff T, Ochsner JL Jr, Meyer M, Brandner L, Babin S. An evaluation of the use of topical tranexamic acid in total knee arthroplasty. J Arthroplasty. 2013 Sep;28(8 Suppl):74-7. doi: 10.1016/j.arth.2013.06.037.
• Background Konig G, Hamlin BR, Waters JH. Topical tranexamic acid reduces blood loss and transfusion rates in total hip and total knee arthroplasty. J Arthroplasty. 2013 Oct;28(9):1473-6. doi: 10.1016/j.arth.2013.06.011. Epub 2013 Jul 23.
• Background Georgiadis AG, Muh SJ, Silverton CD, Weir RM, Laker MW. A prospective double-blind placebo controlled trial of topical tranexamic acid in total knee arthroplasty. J Arthroplasty. 2013 Sep;28(8 Suppl):78-82. doi: 10.1016/j.arth.2013.03.038. Epub 2013 Jul 29.
• Background Yen SH, Lin PC, Chen B, Huang CC, Wang JW. Topical Tranexamic Acid Reduces Blood Loss in Minimally Invasive Total Knee Arthroplasty Receiving Rivaroxaban. Biomed Res Int. 2017;2017:9105645. doi: 10.1155/2017/9105645. Epub 2017 Dec 19.
• Background Rajagopalan V, Chouhan RS, Pandia MP, Lamsal R, Rath GP. Effect of Intraoperative Blood Loss on Perioperative Complications and Neurological Outcome in Adult Patients Undergoing Elective Brain Tumor Surgery. J Neurosci Rural Pract. 2019 Oct;10(4):631-640. doi: 10.1055/s-0039-3399487. Epub 2019 Dec 11.
• Background Walsh PN. The effects of collagen and kaolin on the intrinsic coagulant activity of platelets. Evidence for an alternative pathway in intrinsic coagulation not requiring factor XII. Br J Haematol. 1972 Apr;22(4):393-405. doi: 10.1111/j.1365-2141.1972.tb05687.x. No abstract available.
• Background Gegel BT, Austin PN, Johnson AD. An evidence-based review of the use of a combat gauze (QuikClot) for hemorrhage control. AANA J. 2013 Dec;81(6):453-8.
• Background Motamedi MH, Sagafinia M. QuickClot combat gauze use for hemorrhage control in military trauma. Prehosp Disaster Med. 2011 Jun;26(3):237. doi: 10.1017/S1049023X11006273. No abstract available.
• Background Travers S, Lefort H, Ramdani E, Lemoine S, Jost D, Bignand M, Tourtier JP. Hemostatic dressings in civil prehospital practice: 30 uses of QuikClot Combat Gauze. Eur J Emerg Med. 2016 Oct;23(5):391-4. doi: 10.1097/MEJ.0000000000000318.
• Background Shina A, Lipsky AM, Nadler R, Levi M, Benov A, Ran Y, Yitzhak A, Glassberg E. Prehospital use of hemostatic dressings by the Israel Defense Forces Medical Corps: A case series of 122 patients. J Trauma Acute Care Surg. 2015 Oct;79(4 Suppl 2):S204-9. doi: 10.1097/TA.0000000000000720.
• Background Trabattoni D, Gatto P, Bartorelli AL. A new kaolin-based hemostatic bandage use after coronary diagnostic and interventional procedures. Int J Cardiol. 2012 Apr 5;156(1):53-4. doi: 10.1016/j.ijcard.2010.10.030. Epub 2010 Nov 18.
• Background Derkay CS, Baydoun HA, Stone L. Intraoperative Use of QuikClot During Adenotonsillectomy: A Prospective Pediatric Trial. Ann Otol Rhinol Laryngol. 2015 May;124(5):384-91. doi: 10.1177/0003489414560432. Epub 2014 Nov 25.
• Background Patel SA, Martin M, Chamales I. Vaginal hemorrhage from transobturator sling controlled with QuikClot combat gauze. Mil Med. 2012 Aug;177(8):997-8. doi: 10.7205/milmed-d-11-00429.
• Background Schmid BC, Rezniczek GA, Rolf N, Maul H. Postpartum hemorrhage: use of hemostatic combat gauze. Am J Obstet Gynecol. 2012 Jan;206(1):e12-3. doi: 10.1016/j.ajog.2011.09.018. Epub 2011 Sep 24.
• Background Abbott EM, Nandyala SV, Schwend RM. Does a kaolin-impregnated hemostatic dressing reduce intraoperative blood loss and blood transfusions in pediatric spinal deformity surgery? Spine (Phila Pa 1976). 2014 Sep 1;39(19):E1174-80. doi: 10.1097/BRS.0000000000000466.
• Background Kim K, Shim H, Jung PY, Kim S, Choi YU, Bae KS, Lee JK, Jang JY. Effectiveness of kaolin-impregnated hemostatic gauze use in preperitoneal pelvic packing for patients with pelvic fractures and hemodynamic instability: A propensity score matching analysis. PLoS One. 2020 Jul 24;15(7):e0236645. doi: 10.1371/journal.pone.0236645. eCollection 2020.

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