Abstract Details

Title Safety and Efficacy of Thrombin Gelatin Matrix Sealants in Lumbar Spinal Surgery: A Systematic Review and Meta-analysis

Topic Neuro Trauma and Critical Care

Presentation(s) P3 - Poster Session 3 (5:00 PM-6:00 PM)

Poster/Presentation
Number 19-007

Objective The aim of the study was to evaluate the efficacy and safety of Gelatin Thrombin Matrix Sealants (GTMS) in minimizing blood loss during the perioperative period and preventing complications in patients undergoing lumbar decompression or fusion surgery.

Background Significant intraoperative bleeding during lumbar spine surgery typically complicates the procedure, increasing morbidity, transfusion rates, and length of stay. Conventional hemostatic techniques are frequently ineffective against diffuse venous bleeds and cancellous bone ooze. GTMS (e.g Floseal®,Surgiflo®) provide rapid hemostasis, but their high cost and inconsistent evidence have limited their standardized adoption.

Design/Methods We performed a systematic review and meta-analysis of randomized controlled trials and cohort studies assessing postoperative drain output, hemostasis within 3 minutes, and epidural hematoma as primary outcomes, while intraoperative blood loss, operative time, transfusion rate, and hospital stay were secondary outcomes. Following PRISMA 2020 and PROSPERO (CRD420251145811), we searched PubMed, Cochrane Central, and ClinicalTrials.gov through October 2025 and used random-effects models with SMD, 95% CI, and I² statistics.

Results Eight studies (n =1,207;645 GTMS, 562 control) were included. GTMS significantly reduced postoperative drain output (MD –15.18 mL; 95% CI –20.38 to –9.98; p < 0.0001; I² =0%) and increased hemostasis within 3 minutes (RR 1.30; 95% CI 1.10 to 1.53; p =0.002). Epidural hematoma incidence was lower with GTMS (RR 0.47; 95% CI 0.27 to 0.84; p =0.01). GTMS shortened hospital stay (MD –0.56 days; 95% CI –1.01 to –0.10; p =0.016). Effects on intraoperative blood loss, post-operative transfusion rate and surgical time were not statistically significant. Reported adverse effects were mild and of short duration.

Conclusions GTMS use during lumbar surgery is linked to lower drain output, better intraoperative hemostasis, and fewer epidural hematomas. While these findings support broader use, cost considerations and the need for a standardized procedural approach remain key factors for its adoption in routine clinical practice.

Authors/Disclosures
Basanta Pathak, MBBS PRESENTER	Dr. Pathak has nothing to disclose.
MUHAMMAD HARIS AKRAM, MBBS	Dr. AKRAM has nothing to disclose.
Aiman Javed, Jr., MBBS	Miss Javed has nothing to disclose.
Swaibah Tariq, MBBS	Miss Tariq has nothing to disclose.
Huzaifa S. Nawaz, MBBS	Dr. Nawaz has nothing to disclose.
Muhammad Atif, MBBS	Dr. Atif has nothing to disclose.
Ayesha Ahmed, MBBS	Dr. Ahmed has nothing to disclose.
Haleema Bibi, MBBS	Dr. Bibi has nothing to disclose.
Abdul S. Khan, MBBS	Dr. Khan has nothing to disclose.
Mohammad Hassan, MBBS	Dr. Hassan has nothing to disclose.
Muhammad Wasi Khan, MBBS	Dr. Khan has nothing to disclose.
Amna Iqbal, MBBS	Dr. Iqbal has nothing to disclose.

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