A prospective comparison of topical feracrylum citrate versus adrenaline as haemostatic agent in hypospadias surgery in children

Abstract

Background: A comparative study of topical feracrylum citrate versus adrenaline to minimise haemorrhagerelated complications in paediatric hypospadiac patients.

Patients and Methods: A total of 108 consecutive paediatric hypospadiac patients (48 in the study group and 60 control — random allocation) were studied. In the study group, 1% feracrylum citrate solution was used and adrenaline (1:100,000) in controls.

Results: Among the study group, average number of blood-soaked gauge pieces were 2.95/ patient, correlating with average intraoperative blood loss of 14.74 ml. In controls, average blood-soaked gauge pieces were 4.83/patient corresponding to an average blood loss of 24.13 ml. The average amount of blood loss during surgery in the <5 years was 13.70 ml/patient in the feracrylum group, while the same in the adrenaline group was 23.45 ml. Average duration of surgery was 79 min in the study group, while the same in controls was 94 min/patient. Average number of cauterisations was 0.255/patient in the study group and 0.583/patient among controls. Postoperative haematoma was seen in 8% study group compared with 18% controls. Wound oedema appeared in 4.17% study group and 11.67% controls. Postoperative complications were higher among controls.

Conclusions: Feracrylum is more effi cient and safer topical haemostatic agent than adrenaline. It reduced the frequency of cauterisation and tissue damage, intraoperative blood loss, and postoperative complications.

Key words: Adrenaline, feracrylum citrate, haemostasis, hypospadias surgery