Efficacy of Topical Hemostatic Agents: A Comparative Evaluation of Two Gelatin/Thrombin-Based Hemostatic Matrices in a Porcine Kidney Surgical Model

Slezak, Paul; Heher, Philipp; Monforte, Xavier; Keibl, Claudia; Redl, Heinz; Spazierer, Daniel; Gulle, Heinz

doi:10.1080/08941939.2018.1447619

Cited by 8 publications

(3 citation statements)

References 18 publications

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“…Another study investigating the hemostatic effect of microporous polysaccharide hemospheres on pigs that undergone partial nephrectomy reported the mean hemostasis time as 4,67 minutes for the experimental groups (33). A study comparing two different hemostats on porcine kidney surgical models demonstrated that blood loss decreased similarly after two minutes, however bleeding continued with decreasing rates for the next ten minutes (34). Bang et al in-vestigated the effects of hemostatic powder on acute gastric bleeding in porcine models and evaluated the lesion sites at 6, 18, 42, 66 hours after the application.…”

Section: Discussionmentioning

confidence: 99%

Hemostatic Efficacy of Algan Hemostatic Agent in Renal Vein Incision Model in Rats

Şener

ŞANLI

ABOUHOSA

et al. 2023

Harran Üniversitesi Tıp Fakültesi Dergisi

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Background: The aim of this study is to evaluate the acute hemostatic effects of liquid and powder forms of AHA in severe bleeding model of rat renal vein. Materials and Methods: 10-12 weeks old, 24 male Wistar albino rats were randomly divided into three groups of eight animals each as the control, AHA liquid, AHA powder. The left renal artery and vein were revealed with a 3 cm vertical incision and the tip of the injector was used to puncture renal vein, causing bleeding. In all animals, regular gauze patch was pressed over the incised area for 10 seconds as soon as the bleeding began. Immediately after removing the sponge; physiological saline, AHA liquid and powder were applied with compress to injured site of relevant groups for 2 minutes, respectively. The time was recorded by chronometer and the area was checked after two minutes. Hemostasis that was not achieved after three applications was accepted as failure. Results: Cessation of the bleeding failed in all rats after three successive 2-minute physiological saline impregnated gauze applications in control group. Among AHA-treated groups, significant hemostasis efficacy was obtained from the liquid form than that of powder. Within first two minutes, bleeding in renal veins of five rats was controlled successfully in liquid group whereas powder group achieved hemostatic success in four rats. Conclusions: The vessel incision model in our study revealed fast-acting physical hemostatic properties of the liquid and powder formulations of AHA in the renal vein. This natural applicable product could be used to induce hemostasis in rat models of bleeding caused by various renal damages or trauma, and it could also prevent local bleeding in humans. More studies are needed to compare the efficacy of different formulations of the polysaccharide-based herbal product in various organs and surgical models.

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Section: Discussionmentioning

confidence: 99%

Hemostatic Efficacy of Algan Hemostatic Agent in Renal Vein Incision Model in Rats

Şener

ŞANLI

ABOUHOSA

et al. 2023

Harran Üniversitesi Tıp Fakültesi Dergisi

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“…Given the high cost associated with blood transfusion and its impact on hospital resources, the use of effective hemostats may be associated with potential cost savings due to reductions in transfusions. [23][24] Although our study did not include a formal cost-utility and cost-e cacy analysis, we applied equal volumes (5 ml) in the two groups to increase comparability. In a tertiary-care hospital, CHM costs 40 USD per 1 ml, and GHM costs 80 USD per 1 ml.…”

Section: Discussionmentioning

confidence: 99%

Hemostatic Efficacy of a Flowable Collagen-Thrombin Matrix during Coronary Artery Bypass Grafting: A Double-Blind Randomized Controlled Trial

Kim

Lee

et al. 2022

Preprint

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Background Flowable hemostatic agents have the advantage of being able to be applied to irregular wound surfaces and difficult to reach areas. We sought to compare the effectiveness and safety of the flowable hemostatic sealants Collastat® (collagen hemostatic matrix, [CHM]) and Floseal® (gelatin hemostatic matrix, [GHM]) during off-pump coronary artery bypass (OPCAB). Methods In this prospective, double-blind, randomized controlled trial, 160 patients undergoing elective OPCAB surgery were enrolled between March 2018 and February 2020. After primary suture of the aortocoronary anastomosis, an area of hemorrhage was identified, and patients received either CHM or GHM (n = 80, each). Study endpoints were the following: proportion of successful intraoperative hemostasis and time required for hemostasis overall postoperative bleeding, proportion of transfusion of blood products, and surgical revision for bleeding. Results Of the total patients, 23% were female, and the mean age was 63 years (range: 42–81 years). Successful hemostasis proportion within 5 min was achieved for 78 patients (97.5%) in the GHM group, compared to 80 patients (100%) in the CHM group (non-inferiority p = 0.006). Two patients receiving GHM required surgical revision to achieve hemostasis. There were no differences in the mean time required to obtain hemostasis [GHM vs. CHM, mean 1.49 (SD 0.94) vs. 1.3 (0.60) min, p = 0.272], as confirmed by time-to-event analysis (p = 0.605). The two groups had similar amounts of mediastinal drainage for 24 h postoperatively [538.5 (229.1) vs. 494.7 (190.0) ml, p = 0.298]. The CHM group required less packed red blood cells, fresh frozen plasma, and platelets for transfusion than the GHM group (0.5 vs. 0.7 units per patient, p = 0.047; 17.5% vs. 25.0%, p = 0.034; 7.5% vs. 15.0%, p = 0.032; respectively). Conclusions CHM was associated with a lower need for FFP and platelet transfusions. Thus, CHM is a safe and effective alternative to GHM. Trial registration ClinicalTrials.gov, NCT 04310150

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“…Given the high cost associated with blood transfusion and its impact on hospital resources, the use of effective hemostats may be associated with potential cost savings due to reductions in transfusions. [22][23] Although our study did not include a formal cost-utility and cost-e cacy analysis, we applied equal volumes (5 ml) in the two groups to increase comparability. In a tertiary-care hospital, CHM costs 40 USD per 1 ml, and GHM costs 80 USD per 1 ml.…”

Section: Discussionmentioning

confidence: 99%

Hemostatic Efficacy of a Flowable Collagen-Thrombin Matrix During Coronary Artery Bypass Grafting: A Double-Blind Randomized Controlled Trial

Kim¹,

Lee²,

Lee³

et al. 2021

Preprint

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Background Flowable hemostatic agents are advantageous in that they can be applied to irregular wound surfaces and to areas that are difficult to approach directly. We sought to compare the effectiveness and safety of the flowable hemostatic sealants Collastat® (collagen hemostatic matrix, [CHM]) and Floseal® (gelatin hemostatic matrix, [GHM]) during off-pump coronary artery bypass (OPCAB). Methods In this prospective, randomized trial, 160 patients undergoing elective OPCAB surgery were enrolled between March 2018 and February 2020. After primary suture of the aortocoronary anastomosis, an area of hemorrhage was identified, and patients were double blind randomized to receive either CHM or GHM (n = 80, each). Study endpoints were the following: rate of successful intraoperative hemostasis and time required for hemostasis overall postoperative bleeding, rate of transfusion of blood products, rate of surgical revision for bleeding, postoperative morbidity, and intensive care unit stay. Results Of the total patients, 23% were female, and the mean age was 63 years (range: 42–81 years). Successful hemostasis within 5 min was achieved for 78 patients (97.5%) in the GHM group, compared to 80 patients (100%) in the CHM group (p = 0.497). Two patients receiving GHM required surgical revision to achieve hemostasis. There were no differences in the mean time required to obtain hemostasis (GHM vs. CHM, 1.49 ± 0.94 vs. 1.35 ± 0.60 min, p = 0.272), as confirmed by time-to-event analysis (p = 0.605). The two groups had similar amounts of mediastinal drainage for 24 h postoperatively (p = 0.298). The CHM group required less packed red blood cells, fresh frozen plasma, and platelets for transfusion than the GHM group (0.5 vs. 0.7 units per patient, p = 0.047; 17.5% vs. 25.0%, p = 0.034; 7.5% vs. 15.0%, p = 0.032; respectively). Conclusions CHM performed similarly to a commonly used hemostatic agent with regard to achieving effective and fast interoperative hemostasis during OPCAB. The topical flowable hemostatic agent, CHM, could be effectively used during cardiac surgery for intraoperative hemostasis of great vessels with high pressure. Trial registration : ClinicalTrials.gov, NCT 04310150

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Efficacy of Topical Hemostatic Agents: A Comparative Evaluation of Two Gelatin/Thrombin-Based Hemostatic Matrices in a Porcine Kidney Surgical Model

Cited by 8 publications

References 18 publications

Hemostatic Efficacy of Algan Hemostatic Agent in Renal Vein Incision Model in Rats

Hemostatic Efficacy of Algan Hemostatic Agent in Renal Vein Incision Model in Rats

Hemostatic Efficacy of a Flowable Collagen-Thrombin Matrix during Coronary Artery Bypass Grafting: A Double-Blind Randomized Controlled Trial

Hemostatic Efficacy of a Flowable Collagen-Thrombin Matrix During Coronary Artery Bypass Grafting: A Double-Blind Randomized Controlled Trial

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