Use of a Fibrin Sealant for Surgical Treatment of Pressure Injuries
A cost effectiveness analysis was conducted on the use of Tissucol Duo spray during the surgical treatment of pressure injuries for individuals with SCI (Velasco et al. 2015). Costs and outcomes were based on a retrospective study of 27 individuals who received the fibrin sealant at a Spanish hospital compared to the results of an earlier retrospective study of 71 individuals treated with conventional surgical debridement at the same hospital. The clinical outcomes of interest were hematoma-seroma rates, days to drain removal, the mean volume of drainage, mean length of stay, mean days on antibiotic treatment, the percentage of surgical failure and relapse post-six months. The total hospital cost for individuals receiving the fibrin sealant was about €8,100 less than conventional surgical debridement €23,594.7 versus €31,692.4, 2012 Euros). All outcomes of interest were improved in the sealant cohort including hematoma-seroma rates (3.7% versus 33.8%), removal of the drain (10 days versus 15 days), mean volume of drainage (155ml versus 360 ml), mean length of stay (40 days versus 55 days), percentage of surgical failure (3.7% versus 19.7%) and relapse at six-months (3.7% versus 8.5%). Overall, this study showed lower costs and better outcomes for the study cohort receiving fibrin sealant compared to an earlier cohort receiving conventional surgical debridement.