A novel gelatin sponge for accelerated hemostasis

Abstract

To more effectively manage the substantial bleeding encountered during surgical procedures in oto-rhino-laryngology, we developed a novel hemostatic sponge made of pharmaceutical grade, chemically cross-linked gelatin. The sponge is characterized by a high pore density, reduced ligaments, and a high nanoscale roughness of lamella surfaces in the matrix. In vitro blood uptake assays revealed a very rapid absorption of human blood, which was two to three times faster than that measured with comparative hemostyptic devices. In an in vitro hemorrhage model using human veins, the novel gelatin sponge matrix induced hemostasis less than a minute after bleeding was induced. The sponge was shown to bring about rapid hemostasis when it was administered in a young patient suffering from acute bleeding of a pharyngeal angiofibroma, even though the patient had been treated with an anticoagulant because of a transient ischemic attack. As the gelatin matrix of the sponge is biocompatible and resorbable, the hemostyptic device could be left in place and was shown to be resorbed within 2 weeks. We hypothesize that the excellent hemostatic performance of the sponge might be linked to enhanced capillary effects in conjunction with optimized anchoring of fibrinogen on the nano-rough material surface, as suggested by scanning electron microscopy. The novel gelatin sponge appears to be a promising hemostatic matrix, which could be of great benefit for patients suffering from epistaxis and other acute injuries resulting in severe bleeding.

Soft Collagen-Gelatine Sponges by Convection Drying

“…This was higher than the pore sizes found for freeze-dried collagen sponges (Fig. 5C) or for gelatine sponges (Hajosch et al 2010;Barbetta et al 2010). One of the most important criteria of surgical sponges is the absorption time (ta) of aqueous liquids.…”

Effect of mechanical stress on differentiation of mouse mesenchymal stem cells seeded into an octacalcium phosphate–gelatin scaffold

“…Although we found that OCP has superior osteoconductivity compared to other calcium phosphate materials [19], OCP lacks moldability and has been previously tested in combination with various natural polymers, such as collagen, gelatin, and alginate [13]. Gelatin is a material that has long been used safely and effectively as a biomaterial for medical use [33][34][35]. Moreover, our previous study confirmed that osteoblastic stromal cells attach well to Page 11 of 25 A c c e p t e d M a n u s c r i p t 11 OCP/Gel composite disks [30].…”

Comparison between Gelfoam packing and no packing after endoscopic sinus surgery in the same patients

“…Moreover, Gelfoam is readily designed to the shape and size as surgeons need. Gelfoam has been shown that it has a good hemostatic effect comparable to that of other packing materials [11]. Its surface essentially acts in the intrinsic pathway causing contact activation involving platelets and therefore it has hemostatic activity.…”

“…Gelfoam is gradually absorbed by phagocytosis and usually absorbed in approximately from 4 to 6 weeks [15]. Several trials have suggested that Gelfoam are biocompatible [11] and, in addition, Gelfoam packing has been long used in surgery of chronic otitis media without any complications. Some human studies suggest that absorbable gelatin film may predispose toward the formation of granulation tissue [16,17], whereas others suggest the opposite [17,18].…”

“…However, these materials are quite expensive and therefore, inexpensive absorbable gelatin sponge (Gelfoam Ò , Pharmacia & Upjohn Co., New York, NY) could be considered a new packing material. Gelfoam also has hemostatic effects [11]. However, little agreement exists concerning whether Gelfoam is an optimal sinonasal packing material after FESS.…”