Clinical effectiveness and versatility of a sealing hemostatic patch (HEMOPATCH) in multiple surgical specialties

Abstract

Intraoperative surgical sealants and hemostatic agents have been shown to reduce postoperative complications, transfusions, and hospital resource utilization. Despite availability of these agents, the incidence and burden of bleeding remains high and surgeons' requirements for hemostatic control continue to evolve. A burgeoning class of hemostatic agents are hemostatic patches, which offer package-to-patient readiness and direct application. In addition, hemostatic patches may provide tissue sealing capabilities. Areas covered: This review focuses on the clinical effectiveness, versatility, and surgical efficiency of HEMOPATCH as a surgical sealant and hemostatic agent in various surgical specialties including: cardiac, digestive (hepatic, gastrointestinal, pancreatic), urological, neurological, and endocrine. Expert commentary: Among hemostatic patches, HEMOPATCH is a valuable tool to stop bleeding without adverse events across various surgical specialties. Clinical evidence demonstrates the safety, clinical effectiveness, and versatility of HEMOPATCH as a unique surgical adjunct in patients undergoing complex and routine surgical procedures. Larger randomized-controlled clinical studies, or clinical registries, will continue to be used to evaluate its performance and versatility, particularly for sealing tissues and closing the dura. In the current field of surgical sealing and hemostasis, however, HEMOPATCH represents the next step in improving patient outcomes.

Use of hemostatic agents for surgical bleeding in laparoscopic partial nephrectomy: Biomaterials perspective

“…Veriset™ is a hemostatic pad composed of a neutralized oxidized cellulose sheet impregnated with buffer salts, trilysine, and polyethylene glycol (PEG) derived from nonanimal sources (Öllinger et al, 2013). HEMOPATCH® consists on a collagen patch covered with PEG (Chiara et al, 2018; Lewis, Ikeme, Olubunmi, & Kuntze, 2018). In an early experiment with selected patients, the efficiency of HEMOPATCH® in LPN when used alone or in combination with sutures was reported (Imkamp et al, 2015).…”

“…In an early experiment with selected patients, the efficiency of HEMOPATCH® in LPN when used alone or in combination with sutures was reported (Imkamp et al, 2015). EVARREST® Fibrin Sealant Patch is composed of an oxidized cellulose–polyglactin 910 composite with fibrinogen and thrombin as binding agents (Lewis et al, 2018). The presence of fibrinogen and thrombin results in quick clot formation and good adherence to the bleeding site upon application (Koea et al, 2016).…”

Nanostructured fibrin agarose hydrogel as a novel haemostatic agent

“…In the present study, we explored the haemostatic effectiveness of NFAH, with and without seeded allogeneic fibroblasts, in a partial hepatectomy rat model of short or long hepatic incision (mild or severe hepatic resection, respectively). The performance of the acellular (a‐NFAH) or cellularized (c‐NFAH) scaffold was compared with two commercially available haemostatic products commonly used in multiple surgical procedures: a polyethylene glycol‐coated collagen pad (PCC, Hemopatch®; Lewis, Ikeme, Olubunmi, & Kuntze, ) and a fibrinogen/thrombin‐coated collagen pad (FTC, Tachosil®; Rickenbacher, Breitenstein, Lesurtel, & Frilling, ).…”

PEG-coated patch parenchymal closure technique and initial outcomes during minimally invasive partial nephrectomy

“…The use of this PEG-coated patch for hemostasis has been described across a number of surgical disciplines for both open and laparoscopic procedures. 7,8 One area of concern in laparoscopy is unintentionally activating the PEG-layer on adjacent tissue or blood while positioning the patch, which may complicate the ease of use of this patch in laparoscopy compared to open surgery. 9 Here-in, we describe our initial experience with using a PEG-coated patch in leu of traditional renorrhaphy during MIPN.…”