Prospective clinical trial of gelatin-thrombin matrix as first line treatment of posterior epistaxis.

Abstract

OBJECTIVES/HYPOTHESIS:

To evaluate the effectiveness of gelatin-thrombin matrix for first line treatment of posterior epistaxis. Secondarily, we evaluated discomfort during treatment and the cost savings of treatment with gelatin-thrombin matrix compared to posterior packing, endoscopic, or endovascular treatment at our institution.

STUDY DESIGN:

Prospective pilot, nonblinded, noncontrolled registered clinical trial (NCT01098578).

METHODS:

Twenty patients with posterior epistaxis were enrolled into this study. Gelatin-thrombin matrix was used for posterior epistaxis treatment with simultaneous ipsilateral choanal occlusion. Patients were discharged within 2 hours of being successfully treated. A visual analog scale (range 0-10) was used to assess treatment discomfort. Patients were evaluated in clinic 5 and 30 days after treatment to assess for intranasal complications and recurrent epistaxis.

RESULTS:

Gelatin-thrombin matrix successfully treated epistaxis in 80% of the patients. The procedure was associated with a mean discomfort of 3.6 (range 0-9.7). The institutional per case cost of treatment of patients with posterior epistaxis with gelatin-thrombin matrix is 80.3%, 87.4%, and 89.4% less than with endoscopic surgery, posterior packing, or embolization, respectively. There were no complications.

CONCLUSION:

This pilot study demonstrated that gelatin-thrombin matrix is a safe and both a clinically effective and cost-saving means of treating posterior epistaxis. In this study, its use is associated with a low level of discomfort. This treatment method may improve the quality of care for patients with posterior epistaxis.

• Authors: Shaun J Kilty, Mohammad Al-Hajry, Dakheelallah Al-Mutairi, James P Bonaparte, Melanie Duval, Euna Hwang, Darren Tse
• Journal: The Laryngoscope (Laryngoscope) Vol. 124 Issue 1 Pg. 38-42 (Jan 2014) ISSN: 1531-4995 [Electronic] United States
• PMID: 23754469 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Chemical References

• Hemostatics
• Gelatin
• Thrombin

Topics

• Adult
• Aged
• Aged, 80 and over
• Endoscopy
• Endovascular Procedures
• Epistaxis (therapy)
• Female
• Gelatin (therapeutic use)
• Hemostatics (therapeutic use)
• Humans
• Male
• Middle Aged
• Pilot Projects
• Prospective Studies
• Thrombin (therapeutic use)