Bipolar Sealer Not Superior to Standard Electrocautery in Primary Total Hip Arthroplasty: a Meta-analysis

Overview

Journal J Orthop Surg Res

Publisher Biomed Central

Specialty Orthopedics

Date 2014 Oct 11

PMID 25300445

Citations 4

Authors

Yang Yang

Li-Chao Zhang

Fei Xu

Jia Li

Yong-Ming Lv

Affiliations

Soon will be listed here.

Abstract

Introduction: To assess whether bipolar sealer has advantages over standard electrocautery in primary total hip arthroplasty (THA).

Methods: All studies published through November 2013 were systematically searched in PubMed, Embase, ScienceDirect, The Cochrane Library, and other databases. Relevant journals or conference proceedings were searched manually. Only randomized controlled trials were included. Two independent reviewers identified and assessed the literature. Mean difference in blood loss and risk ratios of transfusion rates and of complication rates in the bipolar sealer group versus the standard electrocautery group were calculated. The meta-analysis was conducted using RevMan 5.1 software.

Results: Five studies were included, with a total sample size of 559 patients. The use of bipolar sealer did not significantly reduce intraoperative blood loss, hemoglobin drop, hospital stay, and operative time. There were no significant differences in need for transfusion and the incidence of infection between the study groups.

Conclusion: The available evidence suggests that the use of bipolar sealer was not superior to standard electrocautery in patients undergoing primary THA. The use of bipolar sealer is not recommended in primary THA.

Citing Articles

Perioperative Blood Management Strategies for Patients Undergoing Total Hip Arthroplasty: Where Do We Currently Stand on This Matter?.

Vrontis K, Tsinaslanidis G, Drosos G, Tzatzairis T Arch Bone Jt Surg. 2020; 8(6):646-655.

PMID: 33313343 PMC: 7718563. DOI: 10.22038/abjs.2020.45651.2249.

Is bipolar sealer superior than standard electrocautery for blood loss control after primary total knee arthroplasty: A meta-analysis.

Chen X, Yang W, Wang X Medicine (Baltimore). 2019; 98(46):e17762.

PMID: 31725616 PMC: 6867738. DOI: 10.1097/MD.0000000000017762.

Effects of tranexamic acid and bipolar sealer alone or in combination in primary total knee arthroplasty: a prospective, randomized, controlled trial.

Seviciu A, Gross I, Fathima S, Walsh S Arthroplast Today. 2017; 2(2):77-82.

PMID: 28326403 PMC: 4957169. DOI: 10.1016/j.artd.2015.12.007.

The Efficacy of Bipolar Sealer on Blood Loss in Primary Total Hip Arthroplasty: A Meta-Analysis.

Min J, Zhang Q, Li H, Li H, Guo P Medicine (Baltimore). 2016; 95(19):e3435.

PMID: 27175643 PMC: 4902485. DOI: 10.1097/MD.0000000000003435.

References

Kumar A . Perioperative management of anemia: limits of blood transfusion and alternatives to it. Cleve Clin J Med. 2009; 76 Suppl 4:S112-8. DOI: 10.3949/ccjm.76.s4.18. View

Toy P, KAPLAN E, McVay P, Lee S, Strauss R, Stehling L . Blood loss and replacement in total hip arthroplasty: a multicenter study. The Preoperative Autologous Blood Donation Study Group. Transfusion. 1992; 32(1):63-7. DOI: 10.1046/j.1537-2995.1992.32192116435.x. View

Falez F, Meo A, Panegrossi G, Favetti F, La Cava F, Casella F . Blood loss reduction in cementless total hip replacement with fibrin spray or bipolar sealer: a randomised controlled trial on ninety five patients. Int Orthop. 2013; 37(7):1213-7. PMC: 3685660. DOI: 10.1007/s00264-013-1903-8. View

Goodnough L, Monk T . Erythropoietin therapy in the perioperative setting. Clin Orthop Relat Res. 1999; (357):82-8. DOI: 10.1097/00003086-199812000-00012. View

Ratcliffe C . Development and implementation of a bloodless medicine and surgery program. J Healthc Manag. 2004; 49(6):405-9. View

Guerra J, Cuckler J . Cost effectiveness of intraoperative autotransfusion in total hip arthroplasty surgery. Clin Orthop Relat Res. 1995; (315):212-22. View

Lemaire R . Strategies for blood management in orthopaedic and trauma surgery. J Bone Joint Surg Br. 2008; 90(9):1128-36. DOI: 10.1302/0301-620X.90B9.21115. View

RITTER E, Demas C, Thompson D, Devereux D . Effects of method of hemostasis on wound-infection rate. Am Surg. 1990; 56(10):648-50. View

Marulanda G, Ulrich S, Seyler T, Delanois R, Mont M . Reductions in blood loss with a bipolar sealer in total hip arthroplasty. Expert Rev Med Devices. 2008; 5(2):125-31. DOI: 10.1586/17434440.5.2.125. View

10.

Biesma D, Marx J, van de Wiel A . Collection of autologous blood before elective hip replacement. A comparison of the results with the collection of two and four units. J Bone Joint Surg Am. 1994; 76(10):1471-5. DOI: 10.2106/00004623-199410000-00006. View

11.

Marulanda G, Ragland P, Seyler T, Mont M . Reductions in blood loss with use of a bipolar sealer for hemostasis in primary total knee arthroplasty. Surg Technol Int. 2006; 14:281-6. View

12.

Hollmann R, Hort C, Kammer E, Naegele M, Sigrist M, Meuli-Simmen C . Smoke in the operating theater: an unregarded source of danger. Plast Reconstr Surg. 2004; 114(2):458-63. DOI: 10.1097/01.prs.0000131886.72932.c3. View

13.

Woolson S, Watt J . Use of autologous blood in total hip replacement. A comprehensive program. J Bone Joint Surg Am. 1991; 73(1):76-80. View

14.

Nuttall G, Santrach P, Oliver Jr W, Horlocker T, Shaughnessy W, Cabanela M . The predictors of red cell transfusions in total hip arthroplasties. Transfusion. 1996; 36(2):144-9. DOI: 10.1046/j.1537-2995.1996.36296181927.x. View

15.

Zeh A, Messer J, Davis J, Vasarhelyi A, Wohlrab D . The Aquamantys system--an alternative to reduce blood loss in primary total hip arthroplasty?. J Arthroplasty. 2010; 25(7):1072-7. DOI: 10.1016/j.arth.2009.10.008. View

16.

Bierbaum B, Callaghan J, Galante J, Rubash H, TOOMS R, Welch R . An analysis of blood management in patients having a total hip or knee arthroplasty. J Bone Joint Surg Am. 1999; 81(1):2-10. DOI: 10.2106/00004623-199901000-00002. View

17.

Itasaka T, Kawai A, Sato T, Mitani S, Inoue H . Diagnosis of infection after total hip arthroplasty. J Orthop Sci. 2001; 6(4):320-6. DOI: 10.1007/s007760100026. View

18.

Nercessian O, Wu H, Nazarian D, Mahmud F . Intraoperative pacemaker dysfunction caused by the use of electrocautery during a total hip arthroplasty. J Arthroplasty. 1998; 13(5):599-602. DOI: 10.1016/s0883-5403(98)90063-8. View

19.

Barsoum W, Klika A, Murray T, Higuera C, Lee H, Krebs V . Prospective randomized evaluation of the need for blood transfusion during primary total hip arthroplasty with use of a bipolar sealer. J Bone Joint Surg Am. 2011; 93(6):513-8. DOI: 10.2106/JBJS.J.00036. View

20.

Tarver H, Oliver S, Ramming G, Englemann B . Techniques to maintain a bloodless field in lower extremity surgery. Orthop Nurs. 2001; 19(4):65-73. DOI: 10.1097/00006416-200019040-00012. View