Efficacy of a kaolin-impregnated gauze in the prevention of postoperative bleeding after cervical conization

Objective: To evaluate the efficacy of a kaolin-impregnated gauze in preventing postoperative bleeding after a loop electrosurgical excision procedure (LEEP). Methods: The medical records of 1322 women who underwent a LEEP at a university hospital were retrospectively reviewed, of which 1006 patients who fulfilled the inclusion criteria were included in the final analysis. During the study period, the bleeding in patients undergoing a LEEP was managed with the application of a kaolin-impregnated gauze (treatment group, n = 539) or without application of a kaolin-impregnated gauze (control group, n = 467). The primary outcome measure was the incidence of postoperative bleeding requiring hemostatic intervention after a LEER A logistic regression model was used to identify the clinical variables for postoperative bleeding. Results: The baseline characteristics were similar between the two study groups. Postoperative vaginal bleeding necessitating an intervention was observed in 12.8% of the study population (129 of 1006 women), with a significant difference between the two groups (9.3% in the treatment group vs. 16.9% in the control group; p < 0.001). On multivariate analysis, significantly lower postoperative bleeding was observed with the use of a kaolin-impregnated gauze than without its use (odds ratio= 0.496; 95% confidence interval = 0.267-0.870; p = 0.009). Conclusions: Prophylactic use of a kaolin-impregnated gauze reduced the incidence of postoperative bleeding after a LEEP.