The effect of TISSEEL fibrin sealant on seroma formation following complex abdominal wall hernia repair

a single institutional review and derived cost analysis

S. C. Azoury, N. Rodriguez-Unda, K. C. Soares, Caitlin Hicks, P. A. Baltodano, K. E. Poruk, Q. L. Hu, Carisa Miller Cooney, P. Cornell, K. Burce, Frederic Eckhauser

Research output: Contribution to journalArticle

Abstract

Purpose: The authors evaluated the ability of a fibrin sealant (TISSEEL™: Baxter Healthcare Corp, Deerfield, IL, USA) to reduce the incidence of post-operative seroma following abdominal wall hernia repair. Methods: We performed a 4-year retrospective review of patients undergoing abdominal wall hernia repair, with and without TISSEEL, by a single surgeon (FEE) at The Johns Hopkins Hospital. Demographics, surgical risk factors, operative data and 30-day outcomes, including wound complications and related interventions, were compared. The quantity and cost of Tisseel per case was reviewed. Results: A total of 250 patients were evaluated: 127 in the TISSEEL group and 123 in the non-TISSEEL control group. The average age for both groups was 56.6 years (P = 0.97). The majority of patients were female (TISSEEL 52.8 %, non-TISSEEL 56.1 %, P = 0.59) and ASA Class III (TISSEEL 56.7 %, non-TISSEEL 58.5 %, P = 0.40). There was no difference in the average defect size for both groups (TISSEEL 217 ± 187.6 cm2, non-TISSEEL 161.3 ± 141.5 cm2, P = 0.36). Surgical site occurrences occurred in 18.1 % of the TISSEEL and 13 % of the non-TISSEEL group (P = 0.27). There was a trend towards an increased incidence of seroma in the TISSEEL group (TISSEEL 11 %, non-TISSEEL 4.9 %, P = 0.07). A total of $124,472.50 was spent on TISSEEL, at an average cost of $995.78 per case. Conclusions: In the largest study to date, TISSEEL™ application offered no advantage for the reduction of post-operative seroma formation following complex abdominal hernia repair. Moreover, the use of this sealant was associated with significant costs.

Original languageEnglish (US)
Pages (from-to)935-942
Number of pages8
JournalHernia
Volume19
Issue number6
DOIs
StatePublished - Dec 1 2015

Fingerprint

Abdominal Hernia
Seroma
Fibrin Tissue Adhesive
Herniorrhaphy
Abdominal Wall
Costs and Cost Analysis
Incidence
Age Groups
Demography
Delivery of Health Care
Control Groups
Wounds and Injuries

Keywords

  • Abdominal wall
  • Fibrin sealant
  • Hernia
  • Seroma
  • TISSEEL

ASJC Scopus subject areas

  • Surgery

Cite this

The effect of TISSEEL fibrin sealant on seroma formation following complex abdominal wall hernia repair : a single institutional review and derived cost analysis. / Azoury, S. C.; Rodriguez-Unda, N.; Soares, K. C.; Hicks, Caitlin; Baltodano, P. A.; Poruk, K. E.; Hu, Q. L.; Cooney, Carisa Miller; Cornell, P.; Burce, K.; Eckhauser, Frederic.

In: Hernia, Vol. 19, No. 6, 01.12.2015, p. 935-942.

Research output: Contribution to journalArticle

Azoury, S. C. ; Rodriguez-Unda, N. ; Soares, K. C. ; Hicks, Caitlin ; Baltodano, P. A. ; Poruk, K. E. ; Hu, Q. L. ; Cooney, Carisa Miller ; Cornell, P. ; Burce, K. ; Eckhauser, Frederic. / The effect of TISSEEL fibrin sealant on seroma formation following complex abdominal wall hernia repair : a single institutional review and derived cost analysis. In: Hernia. 2015 ; Vol. 19, No. 6. pp. 935-942.
@article{14be03a3f8874c61a8385229c74af656,
title = "The effect of TISSEEL fibrin sealant on seroma formation following complex abdominal wall hernia repair: a single institutional review and derived cost analysis",
abstract = "Purpose: The authors evaluated the ability of a fibrin sealant (TISSEEL™: Baxter Healthcare Corp, Deerfield, IL, USA) to reduce the incidence of post-operative seroma following abdominal wall hernia repair. Methods: We performed a 4-year retrospective review of patients undergoing abdominal wall hernia repair, with and without TISSEEL, by a single surgeon (FEE) at The Johns Hopkins Hospital. Demographics, surgical risk factors, operative data and 30-day outcomes, including wound complications and related interventions, were compared. The quantity and cost of Tisseel per case was reviewed. Results: A total of 250 patients were evaluated: 127 in the TISSEEL group and 123 in the non-TISSEEL control group. The average age for both groups was 56.6 years (P = 0.97). The majority of patients were female (TISSEEL 52.8 {\%}, non-TISSEEL 56.1 {\%}, P = 0.59) and ASA Class III (TISSEEL 56.7 {\%}, non-TISSEEL 58.5 {\%}, P = 0.40). There was no difference in the average defect size for both groups (TISSEEL 217 ± 187.6 cm2, non-TISSEEL 161.3 ± 141.5 cm2, P = 0.36). Surgical site occurrences occurred in 18.1 {\%} of the TISSEEL and 13 {\%} of the non-TISSEEL group (P = 0.27). There was a trend towards an increased incidence of seroma in the TISSEEL group (TISSEEL 11 {\%}, non-TISSEEL 4.9 {\%}, P = 0.07). A total of $124,472.50 was spent on TISSEEL, at an average cost of $995.78 per case. Conclusions: In the largest study to date, TISSEEL™ application offered no advantage for the reduction of post-operative seroma formation following complex abdominal hernia repair. Moreover, the use of this sealant was associated with significant costs.",
keywords = "Abdominal wall, Fibrin sealant, Hernia, Seroma, TISSEEL",
author = "Azoury, {S. C.} and N. Rodriguez-Unda and Soares, {K. C.} and Caitlin Hicks and Baltodano, {P. A.} and Poruk, {K. E.} and Hu, {Q. L.} and Cooney, {Carisa Miller} and P. Cornell and K. Burce and Frederic Eckhauser",
year = "2015",
month = "12",
day = "1",
doi = "10.1007/s10029-015-1403-4",
language = "English (US)",
volume = "19",
pages = "935--942",
journal = "Hernia : the journal of hernias and abdominal wall surgery",
issn = "1265-4906",
publisher = "Springer Paris",
number = "6",

}

TY - JOUR

T1 - The effect of TISSEEL fibrin sealant on seroma formation following complex abdominal wall hernia repair

T2 - a single institutional review and derived cost analysis

AU - Azoury, S. C.

AU - Rodriguez-Unda, N.

AU - Soares, K. C.

AU - Hicks, Caitlin

AU - Baltodano, P. A.

AU - Poruk, K. E.

AU - Hu, Q. L.

AU - Cooney, Carisa Miller

AU - Cornell, P.

AU - Burce, K.

AU - Eckhauser, Frederic

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Purpose: The authors evaluated the ability of a fibrin sealant (TISSEEL™: Baxter Healthcare Corp, Deerfield, IL, USA) to reduce the incidence of post-operative seroma following abdominal wall hernia repair. Methods: We performed a 4-year retrospective review of patients undergoing abdominal wall hernia repair, with and without TISSEEL, by a single surgeon (FEE) at The Johns Hopkins Hospital. Demographics, surgical risk factors, operative data and 30-day outcomes, including wound complications and related interventions, were compared. The quantity and cost of Tisseel per case was reviewed. Results: A total of 250 patients were evaluated: 127 in the TISSEEL group and 123 in the non-TISSEEL control group. The average age for both groups was 56.6 years (P = 0.97). The majority of patients were female (TISSEEL 52.8 %, non-TISSEEL 56.1 %, P = 0.59) and ASA Class III (TISSEEL 56.7 %, non-TISSEEL 58.5 %, P = 0.40). There was no difference in the average defect size for both groups (TISSEEL 217 ± 187.6 cm2, non-TISSEEL 161.3 ± 141.5 cm2, P = 0.36). Surgical site occurrences occurred in 18.1 % of the TISSEEL and 13 % of the non-TISSEEL group (P = 0.27). There was a trend towards an increased incidence of seroma in the TISSEEL group (TISSEEL 11 %, non-TISSEEL 4.9 %, P = 0.07). A total of $124,472.50 was spent on TISSEEL, at an average cost of $995.78 per case. Conclusions: In the largest study to date, TISSEEL™ application offered no advantage for the reduction of post-operative seroma formation following complex abdominal hernia repair. Moreover, the use of this sealant was associated with significant costs.

AB - Purpose: The authors evaluated the ability of a fibrin sealant (TISSEEL™: Baxter Healthcare Corp, Deerfield, IL, USA) to reduce the incidence of post-operative seroma following abdominal wall hernia repair. Methods: We performed a 4-year retrospective review of patients undergoing abdominal wall hernia repair, with and without TISSEEL, by a single surgeon (FEE) at The Johns Hopkins Hospital. Demographics, surgical risk factors, operative data and 30-day outcomes, including wound complications and related interventions, were compared. The quantity and cost of Tisseel per case was reviewed. Results: A total of 250 patients were evaluated: 127 in the TISSEEL group and 123 in the non-TISSEEL control group. The average age for both groups was 56.6 years (P = 0.97). The majority of patients were female (TISSEEL 52.8 %, non-TISSEEL 56.1 %, P = 0.59) and ASA Class III (TISSEEL 56.7 %, non-TISSEEL 58.5 %, P = 0.40). There was no difference in the average defect size for both groups (TISSEEL 217 ± 187.6 cm2, non-TISSEEL 161.3 ± 141.5 cm2, P = 0.36). Surgical site occurrences occurred in 18.1 % of the TISSEEL and 13 % of the non-TISSEEL group (P = 0.27). There was a trend towards an increased incidence of seroma in the TISSEEL group (TISSEEL 11 %, non-TISSEEL 4.9 %, P = 0.07). A total of $124,472.50 was spent on TISSEEL, at an average cost of $995.78 per case. Conclusions: In the largest study to date, TISSEEL™ application offered no advantage for the reduction of post-operative seroma formation following complex abdominal hernia repair. Moreover, the use of this sealant was associated with significant costs.

KW - Abdominal wall

KW - Fibrin sealant

KW - Hernia

KW - Seroma

KW - TISSEEL

UR - http://www.scopus.com/inward/record.url?scp=84948381529&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84948381529&partnerID=8YFLogxK

U2 - 10.1007/s10029-015-1403-4

DO - 10.1007/s10029-015-1403-4

M3 - Article

VL - 19

SP - 935

EP - 942

JO - Hernia : the journal of hernias and abdominal wall surgery

JF - Hernia : the journal of hernias and abdominal wall surgery

SN - 1265-4906

IS - 6

ER -