Hemostatic Agents in Hepatobiliary and Pancreas Surgery: A Review of the Literature and Critical Evaluation of a Novel Carrier-Bound Fibrin Sealant (TachoSil)

Simo, Kerri A.; Hanna, Erin M.; Imagawa, David K.; Iannitti, David A.

doi:10.5402/2012/729086

Cited by 34 publications

(30 citation statements)

References 54 publications

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“…A recent review of fibrin sealant in hepatic surgery, also supports the findings [217] that fibrin sealant may be an effective hemostat but thus far does not seem to reduce complications. One multicenter, prospective, randomized study [214] suggested that a patch composed of polyethylene glycol, trilysine amine, and oxidized regenerated cellulose ( n = 32) was superior to a fibrin sealant-equine collagen patch ( n = 18) in terms of median time to hemostasis (1.0 versus 3.0 min, P < 0.001) during hepatic resection.…”

Section: Less Frequently Published Clinical Applications Of Fibrinmentioning

confidence: 67%

Fibrin Sealant: The Only Approved Hemostat, Sealant, and Adhesive—a Laboratory and Clinical Perspective

2014

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Background. Fibrin sealant became the first modern era material approved as a hemostat in the United States in 1998. It is the only agent presently approved as a hemostat, sealant, and adhesive by the Food and Drug Administration (FDA). The product is now supplied as patches in addition to the original liquid formulations. Both laboratory and clinical uses of fibrin sealant continue to grow. The new literature on this material also continues to proliferate rapidly (approximately 200 papers/year). Methods. An overview of current fibrin sealant products and their approved uses and a comprehensive PubMed based review of the recent literature (February 2012, through March 2013) on the laboratory and clinical use of fibrin sealant are provided. Product information is organized into sections based on a classification system for commercially available materials. Publications are presented in sections based on both laboratory research and clinical topics are listed in order of decreasing frequency. Results. Fibrin sealant remains useful hemostat, sealant, and adhesive. New formulations and applications continue to be developed. Conclusions. This agent remains clinically important with the recent introduction of new commercially available products. Fibrin sealant has multiple new uses that should result in further improvements in patient care.

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Section: Less Frequently Published Clinical Applications Of Fibrinmentioning

confidence: 67%

Fibrin Sealant: The Only Approved Hemostat, Sealant, and Adhesive—a Laboratory and Clinical Perspective

2014

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“…ORC conducts hemostatic action through blood absorption, surface interaction with platelets (PLTs) and proteins, and coagulation cascade activation 11. Since its introduction in 1943, several commercial ORC products have been developed,12 and are now frequently used in most gastrointestinal and non-gastrointestinal operations 1314…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Oxidized Regenerated Cellulose, SurgiGuard®, in Porcine Surgery

Kim

Yoon³

et al. 2017

Yonsei Med J

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PurposeAdequate hemostasis is important for postoperative outcomes of abdominal surgery. This study evaluated the hemostatic effects and accompanying histopathological changes of a novel oxidized regenerated cellulose, SurgiGuard®, during abdominal surgery.Materials and MethodsTen pigs underwent wedge resection of the spleen (1×1 cm) and liver (1.5×1.5 cm). The resected surface was covered with Surgicel® fabric or fibril type (Group A) or SurgiGuard® fabric or fibril type (Group B). Surgicel® and SurgiGuard® were randomized for attachment to the resected surface by fabric type (n=5) or fibril type (n=5). Blood loss was measured 5, 7, and 9 min after resection. Pigs were necropsied 6 weeks postoperatively to evaluate gross and histopathological changes.ResultsThere was no significant difference in total blood loss between groups [spleen fabric: Group A vs. Group B, 4.38 g (2.74–6.43) vs. 3.41 g (2.46–4.65), p=0.436; spleen fibril: Group A vs. Group B, 3.44 g (2.82–6.07) vs. 3.60 g (2.03–6.09), p=0.971; liver fabric: Group A vs. Group B, 4.51 g (2.67–10.61) vs. 6.93 g (3.09–9.95), p=0.796; liver fibril: Group A vs. Group B, 3.32 g (2.50–8.78) vs. 3.70 g (2.32–5.84), p=0.971]. Histopathological analysis revealed no significant difference in toxicities related to Surgicel® or SurgiGuard® [inflammation, fibrosis, foreign bodies, and hemorrhage (spleen: p=0.333, 0.127, 0.751, and 1.000; liver: p=0.155, 0.751, 1.000, and 1.000, respectively)].ConclusionSurgiGuard® is as effective and non-toxic as Surgicel® in achieving hemostasis after porcine abdominal surgery.

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“…Время остановки кровотечения определяют по прекращению истечения крови после очередного снятия местного гемоста-тика [39] (губки, пленчатого импланта и др.) с поверхности раны.…”

Section: методы исследования гемостатической активности аппликационныunclassified

To the Issue of Methodology of Comparative Study of the Degree of Hemostatic Activity of Topical Hemostatic Agents

Липатов¹,

Lazarenko²,

Sotnikov³

et al. 2018

Novosti Khirurgii

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В настоящее время интенсивно разрабатываются новые лекарственные средства, влияющие на си-стему гемостаза, и локально действующие кровоостанавливающие средства. Новые образцы разрабатыва-емых средств требуют объективного высокоточного сравнительного изучения их эффективности. Однако, несмотря на сложившуюся ситуацию, вопрос выбора методов оценки гемостатической активности ле-карственных средств и кровоостанавливающих имплантов (как в клинической практике, так и в экспе-рименте) остается открытым. В связи с этим авторами были проанализированы современные, наиболее распространенные методики, комбинации оцениваемых показателей гемостаза и методов исследования ге-мостатической активности лекарственных средств и имплантов (in vitro et in vivo), описаны преимущества и недостатки данных методов, а также предложены их наиболее эффективные сочетания. Авторы пред-лагают алгоритм выбора кровоостанавливающих средств, разрабатываемых с целью их применения при оперативных вмешательствах преимущественно на паренхиматозных органах брюшной полости. Алгоритм основан на этапности использования различных методик (I этап -скрининг-исследование физико-меха-нических и гемостатических свойств имплантов методиками in vitro, II этап -метод «острого» опыта in vivo для определения продолжительности кровотечения и объема кровопотери, III этап -метод «хронического» эксперимента in vivo (исследование выраженности реакции тканей животного на имплант при подкожной имплантации и моделированной травме паренхиматозных органов и пр.)), позволяющих всесторонне из-учить кровоостанавливающую способность аппликационных гемостатических имплантов и исключить воз-можные негативные эффекты при их применении. Ключевые слова: гемостаз, гемостатические средства, паренхиматозные органы, гемостатическая губ-ка, аппликационные импланты, кровотечение, кровопотеря, сгустокAt present new drugs affecting the hemostasis system and locally affecting hemostatic agents are being intensively developed. New types of the developed substances require highly objective and precise comparative methods for efficiency measuring. However, despite the current situation, the choice of methods for assessing the haemostatic activity of drugs and hemostatic implants (both in clinical practice and in experiment) remains open. In this regard, the authors have analyzed most common modern methods, combinations of the evaluated hemostasis indicators and methods for studying hemostatic activity of drugs and implants (in vitro and in vivo); the advantages and disadvantages of these methods are described and their most effective combinations are proposed. The authors propose the algorithm for the selection of hemostatic agents developed for the purpose of their application in surgical interventions primarily on the parenchymal organs of the abdominal cavity. The algorithm is based on the phasing of using various techniques (I step -a screening study of physic-mechanical and hemostatic properties in vitro implant procedures, II step -the method of "acute" experience in vivo for determining ble...

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Hemostatic Agents in Hepatobiliary and Pancreas Surgery: A Review of the Literature and Critical Evaluation of a Novel Carrier-Bound Fibrin Sealant (TachoSil)

Cited by 34 publications

References 54 publications

Fibrin Sealant: The Only Approved Hemostat, Sealant, and Adhesive—a Laboratory and Clinical Perspective

Fibrin Sealant: The Only Approved Hemostat, Sealant, and Adhesive—a Laboratory and Clinical Perspective

Efficacy of Oxidized Regenerated Cellulose, SurgiGuard®, in Porcine Surgery

To the Issue of Methodology of Comparative Study of the Degree of Hemostatic Activity of Topical Hemostatic Agents

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