Evaluating the role of the self-assembling topical haemostat PuraBond® in Transoral Robotic Surgery (TORS) for oropharyngeal cancer: A case series

Gupta, Keshav Kumar; Garas, George; Idle, Matthew; Germain, Susan; De, Mriganka

doi:10.1016/j.amsu.2022.104302

Cited by 3 publications

(2 citation statements)

References 40 publications

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“…In line with the criteria of consensus-based guidelines for case reports (SCARE), [178] the hemostatic effectiveness of RADA16 peptide hydrogel not only reduced rebleeding rate and minimized the post-operative adhesion formation and but also ameliorated the scar tissue formation in injured mucosal surface and subsequent re-stenosis. Except for endoscopic nasal surgery, dSAP biomaterials may expand to oral, nasopharyngeal mucosa, and other anatomical regions of the upper aerodigestive tract with oropharyngeal cancer, [179] which may serve as an epithelial regeneration substrate and offer potential superiority over present "goldstandard" materials (collagen, etc.). [180] Compared with other nasal packing dressings that were widely utilized to prevent intraoperative bleeding, decrease post-operative adhesion formation, and impede the lateralization of middle turbinate and incoming blockage of sinus drainage pathway, such as NasoPore (Polyganics, The Netherlands), [181] Gelfoam (Pfizer, USA), [182] and the selfpropelling hemostatic agent of thrombin and tranexamic acid (SPTT), [183] RADA16 peptide hydrogel biomaterial was a nanofibrous multifunctional space filling matrix which might effectively control intraoperative bleedings and prevent sinonasal adhesion between the injured mucosal surfaces.…”

Section: Hemostatic Use In Endoscopic Nasal Surgerymentioning

confidence: 99%

Short Peptide Nanofiber Biomaterials Ameliorate Local Hemostatic Capacity of Surgical Materials and Intraoperative Hemostatic Applications in Clinics

et al. 2023

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Short designer self‐assembling peptide (dSAP) biomaterials are a new addition to the hemostat group. It may provide a diverse and robust toolbox for surgeons to integrate wound microenvironment with much safer and stronger hemostatic capacity than conventional materials and hemostatic agents. Especially in noncompressible torso hemorrhage (NCTH), diffuse mucosal surface bleeding, and internal medical bleeding (IMB), with respect to the optimal hemostatic formulation, dSAP biomaterials are the ingenious nanofiber alternatives to make bioactive neural scaffold, nasal packing, large mucosal surface coverage in gastrointestinal surgery (esophagus, gastric lesion, duodenum, and lower digestive tract), epicardiac cell‐delivery carrier, transparent matrix barrier, and so on. Herein, in multiple surgical specialties, dSAP‐biomaterial‐based nano‐hemostats achieve safe, effective, and immediate hemostasis, facile wound healing, and potentially reduce the risks in delayed bleeding, rebleeding, post‐operative bleeding, or related complications. The biosafety in vivo, bleeding indications, tissue‐sealing quality, surgical feasibility, and local usability are addressed comprehensively and sequentially and pursued to develop useful surgical techniques with better hemostatic performance. Here, the state of the art and all‐round advancements of nano‐hemostatic approaches in surgery are provided. Relevant critical insights will inspire exciting investigations on peptide nanotechnology, next‐generation biomaterials, and better promising prospects in clinics.

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Section: Hemostatic Use In Endoscopic Nasal Surgerymentioning

confidence: 99%

Short Peptide Nanofiber Biomaterials Ameliorate Local Hemostatic Capacity of Surgical Materials and Intraoperative Hemostatic Applications in Clinics

et al. 2023

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“…There is a risk for hemorrhage by using Transoral Robotic Surgery for human papillomavirus positive early-stage oropharyngeal squamous cell carcinoma (Leonhardt et al, 2012;Moore et al, 2012;Chen et al, 2015). A hemostatic agent from the RADA16 family, PuraBond ® , was used as an adjunct during Transoral Robotic Surgery (Gupta et al, 2022). Preliminary findings showed none of the patients developed primary or secondary hemorrhage post-transoral robotic surgery in conjunction with PuraBond ® .…”

Section: Future Directionsmentioning

confidence: 99%

Self-assembling peptides as immunomodulatory biomaterials

Hernández

Hartgerink²,

Young³

2023

Front. Bioeng. Biotechnol.

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Self-assembling peptides are a type of biomaterial rapidly emerging in the fields of biomedicine and material sciences due to their promise in biocompatibility and effectiveness at controlled release. These self-assembling peptides can form diverse nanostructures in response to molecular interactions, making them versatile materials. Once assembled, the peptides can mimic biological functions and provide a combinatorial delivery of therapeutics such as cytokines and drugs. These self-assembling peptides are showing success in biomedical settings yet face unique challenges that must be addressed to be widely applied in the clinic. Herein, we describe self-assembling peptides’ characteristics and current applications in immunomodulatory therapeutics.

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Application of the Self-Assembling Peptide Hydrogel RADA16 for Hemostasis during Tonsillectomy: A Feasibility Study

Michaels,

Kaleva,

Bateman

et al. 2024

JFB

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Tonsillectomy is a common surgical procedure but carries a high risk of readmission for secondary bleeding and pain. This study evaluated the feasibility and effectiveness of using the hemostatic self-assembling peptide hydrogel RADA16 (PuraBond, 3-D Matrix SAS; Caluire et Cuire, France) to control bleeding from the tonsillectomy wound bed. Readmission/re-operation rates were compared between a prospective case series of 21 primarily adult tonsillectomy patients treated with topical RADA16 and an untreated historical Control group of 164 patients who underwent tonsillectomy by 10 surgeons at a single tertiary hospital in the UK between March 2019 and June 2022. Cumulative readmission rates for any reason were 2-fold elevated in Control subjects (18.9%; n = 31/164 subjects) compared to patients treated intra-operatively with RADA16 hemostatic hydrogel (9.5%; n = 2/21) (p = 0.378). Readmission rates for postoperative bleeding were 3-fold higher in Controls (14.6%; n = 24/164 subjects) than in the RADA16-treated group (4.8%; n = 1/21) (p = 0.317). A similar rate of retreatment for pain was recorded in the Control (4.3%; n = 7/164) and RADA16 (4.8%; n = 1/21) groups (p = 0.999). Two Control subjects (1.2%) required re-operation for recalcitrant bleeding; no RADA16 subject (0.0%) required re-operation for any reason. No device-related adverse events occurred in the RADA16 group. Surgeons were pleased with the easy learning curve and technical feasibility associated with intra-operatively administering RADA16 hemostatic hydrogel. Intra-operative hemostasis using RADA16 peptide hydrogel was straightforward and was associated with a trend of 3-fold lower rates of readmission for postoperative bleeding events than untreated Control subjects.

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Evaluating the role of the self-assembling topical haemostat PuraBond® in Transoral Robotic Surgery (TORS) for oropharyngeal cancer: A case series

Cited by 3 publications

References 40 publications

Short Peptide Nanofiber Biomaterials Ameliorate Local Hemostatic Capacity of Surgical Materials and Intraoperative Hemostatic Applications in Clinics

Short Peptide Nanofiber Biomaterials Ameliorate Local Hemostatic Capacity of Surgical Materials and Intraoperative Hemostatic Applications in Clinics

Self-assembling peptides as immunomodulatory biomaterials

Application of the Self-Assembling Peptide Hydrogel RADA16 for Hemostasis during Tonsillectomy: A Feasibility Study

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