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Circulating Cytokines In Patients Undergoing Tonsillectomy With Fibrin Glue | 12395
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Objective:
Fibrin glue is used as a haemostatic agent or as a sealant. The aim of this study is to objectively evaluate the efficacy of the use of
fibrin glue Quixil � a human surgical sealer � in tonsillectomy, for the reduction of post-operative inflammatory response.
Study design:
A prospective randomized single-blind study.
Methods:
The study was performed on 40 consecutive patients undergoing adenotonsillectomy (T&A). Patients were randomly assigned to
one of two sub-groups: a study group and a control group.
The tonsillar beds of patients in the study group were coated with fibrin glue (Quixil, OMRIX biopharmaceuticals) at the end of the
operation; the patients in the control group were treated for hemostasis without the use of fibrin glue.
Complete blood counts and circulating pro-inflammatory cytokines (assayed by specific immunoassay � ELISA) were assessed in samples
drawn pre- and 16 hours post-tonsillectomy.
Results:
Forty patients (aged 5.8�2.4 y) were consecutively enrolled; 45% (18) of the patients were treated with fibrin glue, 55% (22) were
not. Compared to controls, Quixil-treated patients demonstrated a reduction in post-tonsillectomy circulating leukocytes (29.2% vs. 45.4%,
p<0.05), neutrophiles (28.3% vs. 42.1%, p<0.05), IL-6 (+1% vs. +42%, p<0.05), and TNF-alpha (+8% vs. +26%, p<0.05.
Conclusions:
Intra-operative fibrin glue therapy is associated with decreased immediate inflammatory response following T&A. Further
studies are warranted to assess long term outcome.
Level of evidence:
1B
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