Southeast Missouri Hospital Finds Cost Advantages Using Platelet Gel

Hospital eliminated $88,000 in mediastinitis-related costs

AUGUST 2008

Looking to control costs and improve patient care, Southeast Missouri Hospital began to study the effects of using autologous platelet gel (APG) for cardiac surgery procedures. After a two year study, the team discovered it lowered costs by reducing the need for expensive surgical glues and eliminated costs associated with mediastinitis.

The perfusion team started using platelet gel primarily as an alternative to using surgical adhesives and cryoprecitate on anastomosis sites, and found that platelet gel provided excellent hemostatic benefits.

“I think platelet rich plasma does an excellent job,” says Randy G. Brown, MD, Chief Cardiothoracic Surgeon, Southeast Missouri Hospital.

This team’s investigation into the medical and cost benefits of using platelet gel in cardiac surgery ultimately justified the use. A retrospective, observational study was conducted to evaluate the possible effects of APG and the reduction of mediastinitis after gel was used on every open heart patient for the past two years at Southeast Missouri Hospital.

According to infection control and outcomes management at the hospital, there were no cases of mediastinitis in 2006 and 2007. Its study revealed two cases of mediastinitis secondary to open heart surgery in 2005. A cost analysis involving the two infections provided the following:

• The average extra length of stay was 18.1 days
• The average extra cost was $44,070 per incidence

The Southeast Missouri Hospital study highlighted the benefits of using APG, especially the fact that autologous platelet gel reduces bleeding as well as the incidence of sternal infections.

Gel replaces glue

“Secondary to stopping bleeding and oozing, we use platelet gel to improve healing on the sternum and leg wounds,” says Terry L. Seacrist, CCP, Chief Perfusionist at Southeast Missouri Hospital. “And we started seeing good results.”

The catalyst that initiated the use of autologous platelet gel was the discovery that in more than 60% of the open heart surgeries, the surgeons were using a physiologic glue – either surgical adhesives or cryoprecipitate – on distal anastamoses.

In 2003 the hospital’s cost for cryoprecipitate was $458 per use. The surgeons also used biosynthetic glues for similar purposes – with costs ranging from $495 to $795 per use.

Surgeons like results

“If we could get a good gel with platelet rich plasma, we could cease using cryoprecipitate and surgical adhesives,” says Ms. Seacrist. “We looked at the costs of disposables for the SmartPReP™2 Platelet Concentrate System and surgeons were pretty happy with the results.”

“I don’t like the glues,” adds Dr. Brown. “They set up very hard, are not as pliable and can end up causing complications with the graft.”

“I can definitely say platelet rich plasma decreases post-op bleeding. I sleep better at night knowing I’ve used platelet gel,” says Dr. Brown. “There’s less chest tube drainage, bruising and swelling compared to five to 10 years ago before we started using platelet gel.”