Laparoscopic repair of inferior vena caval injury using a chitosan-based hemostatic dressing

Xie, Hua; Teach, Jeffrey S.; Burke, Allen; Lucchesi, Lisa; Wu, Ping Cheng; Sarao, Rebecca C.

doi:10.1016/j.amjsurg.2007.12.050

Cited by 14 publications

(8 citation statements)

References 12 publications

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“…2 This allows the processing of chitosan into fibers and films, as well as the ability to prepare high purity chitosan for biomedical use. Chitosan has been found to have good biocompatibility for a range of biomedical applications, including use as an excipient, 3 hemostatic agent, [4][5][6][7][8] anti-microbial agent, [9][10][11] and in wound dressings. 4,9,[11][12][13] There is substantial evidence that chitosan promotes wound healing.…”

Section: Introductionmentioning

confidence: 99%

Chitosan dressing promotes healing in third degree burns in mice: Gene expression analysis shows biphasic effects for rapid tissue regeneration and decreased fibrotic signaling

Baxter

Dai

Kimball

et al. 2012

J Biomedical Materials Res

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Burns are a significant health challenge and healing can result in scar formation. Chitosan, a derivative of chitin, has been used to promote wound healing. In this study we used gene expression profiling in a mouse model of full thickness cutaneous burn to assess the benefits of treating with a chitosan lactate dressing. Three days after wounding mice treated with chitosan showed increased expression of genes associated with formation of granulation tissue. At a later time point, seven days after wounding, genes that initially showed increased expression were now down‐regulated, and there was increased expression of genes involved in remodeling suggesting that the chitosan treatment results in accelerated healing. Quantitative RT‐PCR showed modulated mRNA levels for TGFβ1 by the chitosan dressing. TGFβ1 initially promotes healing but extended activity can result in scarring. Importantly we found that expression was elevated at day three, but decreased at day seven suggesting that chitosan treatment will not result in scar formation, and may even be beneficial in preventing scar formation. Additionally, the biphasic regulation of expression of TGFβ1 could be a powerful biomarker for future studies of the wound‐healing potential of chitosan based and other treatments for burn wounds. © 2012 Wiley Periodicals, Inc. J Biomed Mater Res Part A, 2013.

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Section: Introductionmentioning

confidence: 99%

Chitosan dressing promotes healing in third degree burns in mice: Gene expression analysis shows biphasic effects for rapid tissue regeneration and decreased fibrotic signaling

Baxter

Dai

Kimball

et al. 2012

J Biomedical Materials Res

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“…Different forms of the chitosan dressing have been developed to enhance hemostasis involving bleeding from varying external wounds,1 oral wounds,14 and vessel puncture sites 15. In our previous studies, a new platform of the chitosan dressing was investigated to arrest life threatening hemorrhaging in inferior vena cava injury and renal parenchymal resection with laparoscopic technique 2, 3. The CHD is able to stop parenchymal bleeding and urinary extravasation by sealing the wound surface with its adhesion property.…”

Section: Discussionmentioning

confidence: 99%

“…All procedures for handling and caring of the animals were carried out in accordance with the guideline of 1996 National Research Council's “Guide for the Care and Use of Laboratory Animals,” and approved by the local Institutional Animal Care and Use Committee. The chitosan surgical hemostatic dressing (CHD, HemCon Medical Technologies, Portland, OR) has been described in our previous studies 2, 3. Surgicel (Surgicel ® , Ethicon, NJ) and Fibrin glue (Tisseel ® Fibrin Sealant, Baxter, CA) were purchased from our hospital.…”

Section: Methodsmentioning

confidence: 99%

“…A new Chitosan hemostatic dressing (CHD) directly derived from the original platform design including a bioabsorbable backing had been developed for internal surgical application. Our previous studies demonstrated that the CHD provides an effective hemostasis in LPN and vena cava injury repair and simplifies the operation maneuver in these laparoscopic procedures 2, 3. In this study, we investigated the long‐term safety and efficacy of CHD following LPN application.…”

Section: Introductionmentioning

confidence: 99%

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Long‐term outcomes of a chitosan hemostatic dressing in laparoscopic partial nephrectomy

et al. 2011

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This study examined the long-term safety and effectiveness of a chitosan hemostatic dressing (CHD) in a porcine laparoscopic partial nephrectomy (LPN) model. Eighteen miniswine underwent treatment of using CHD or Surgicel(®) and Tisseel(®) (S/T) for renal parenchymal hemostasis after LPN. The animals were followed up for 6 and 12 months. Surgical procedure related complications, hematological and blood chemical changes were monitored. Histopathological examination was performed on the treated and untreated tissue and organs. All animals had initial hemostasis and survived without any immediate or delayed complications in both CHD and S/T groups. The animals with CHD treatment left large amounts of chitosan residuals on the resected kidney that associated with greater inflammatory scores when compared to the S/T treated animals. This long-term study showed that CHD residuals remained for 12 months and resulted in local inflammation in the LPN model. Despite lack of signs and symptoms of clinical significance in the animals, a further investigation should be conducted to understand the risk of slow degradation of CHD.

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“…New and consistent data from animal models of severe hemorrhage indicated that chitosan-based hemostatic gauze dressings developed for battlefield application are at least as effective as QuikClot Combat Gauze. Nine studies reported good efficacy and equivalence of chitosan-based gauze dressings with QuikClot Combat Gauze dressing in preclinical extremity arterial hemorrhage models, [41][42][43][44][45][46][47][48][49] as concluded in a formal review. 15 Additional peer-reviewed studies report successful outcomes using newer chitosan-based dressings (Celox Gauze, MedTrade Products Ltd, Crew, UK) in civilian hospital-based case reports [50][51][52] and prehospital (battlefield) case reports and series.…”

Section: Bennett S40mentioning

confidence: 99%

Bleeding Control Using Hemostatic Dressings: Lessons Learned

Bennett

2017

Wilderness & Environmental Medicine

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Based on lessons learned, many military battlefield trauma advances ultimately transition to enhance civilian trauma care. However, even with major strides to enhance battlefield hemorrhage control, it is unclear how effectively these techniques and products are being translated to civilian trauma. The purpose of this brief review is to present the evidence of current hemostatic product effectiveness, determine the evidence for transitioning of this technology to prehospital civilian application, and provide recommendations about potential use in the wilderness/austere setting. It is concluded that there is adequate evidence of hemorrhage control effectiveness in both military and civilian preclinical studies and clinical case series. The Committee on Tactical Combat Casualty Care recommends implementing approved hemostatic dressings as one part of a comprehensive hemorrhage control training and clinical management program. These recommendations for hemostatic dressings use by public safety and laypersons should be applied in acute transport urban settings or during prolonged care in austere environments.

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Laparoscopic repair of inferior vena caval injury using a chitosan-based hemostatic dressing

Cited by 14 publications

References 12 publications

Chitosan dressing promotes healing in third degree burns in mice: Gene expression analysis shows biphasic effects for rapid tissue regeneration and decreased fibrotic signaling

Chitosan dressing promotes healing in third degree burns in mice: Gene expression analysis shows biphasic effects for rapid tissue regeneration and decreased fibrotic signaling

Long‐term outcomes of a chitosan hemostatic dressing in laparoscopic partial nephrectomy

Bleeding Control Using Hemostatic Dressings: Lessons Learned

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