Properties of collagen-based hemostatic patch compared to oxidized cellulose-based patch

Abstract

Two self-adhering hemostatic patches, based on either PEG-coated collagen (PCC) or PEG-coated oxidized cellulose (PCOC), are compared regarding to maximum burst pressure, mechanical stability, and swelling. In addition, the induction of tissue adhesions by the materials was assessed in a rabbit liver abrasion model. Both materials showed comparable sealing efficacy in a burst pressure test (37 ± 16 vs. 35 ± 8 mmHg, P = 0.730). After incubation in human plasma, PCC retained its mechanical properties over the test period of 8 h, while PCOC showed faster degradation after the 2 h time-point. The degradation led to a significantly decreased force at break (minimum force at break 0.55 N during 8 h for PCC, 0.27 N for PCOC; p < 0.001). Further, PCC allowed significantly higher deformation before break (52% after 4 h and 50% after 8 h for PCC, 18% after 4 h and 23% after 8 h for PCOC; p = 0.003 and p < 0.001 for 4 h and 8 h, respectively) and showed less swelling in human plasma (maximum increase in thickness: ~20% PCC, ~100% PCOC). Faster degradation of PCOC was visible macroscopically and histologically in vivo after 14 days. PCC showed visible structural residues with little cellular infiltration while strong infiltration with no remaining structural material was seen with PCOC. In vivo, a higher incidence of adhesion formation after PCOC application was detected. In conclusion, PCC has more reliable mechanical properties, reduced swelling, and less adhesion formation than PCOC. PCC may offer greater clinical benefit for surgeons in procedures that have potential risk for body fluid leakage or that require prolonged mechanical stability.

Efficacy of a novel polyoxazoline based hemostatic patch in liver and spleen surgery

“…Histological results up till six weeks of NHS-POx-based patches were comparable with control patches and point into the direction of clinical safety. Degradation of the experimental patch showed a linear pattern, corresponding with our and previous ndings in commercial control patches (29,30). Although active GFC-NHS-POx patch seemed to degrade more slowly compared to the GFC blank, it was complete within 4-6 week.…”

Versatility and clinical effectiveness of a synthetic sealing hemostatic patch as alternative to parenchyma suturing in laparoscopic partial nephrectomy

“…Veriset™ is a ready-to-use hemostatic patch designed for endoscopic and open surgery. The patch contains of oxidized cellulose and is impregnated with buffer salts, trilysine and a reactive polyethylene glycol and does not contain human or animal coagulation factors [ 21 ]. For its activation, the device needs contact with blood and fluids to form covalent bonds with blood proteins and the underlying tissue.…”

Hemostats in Spine Surgery: Literature Review and Expert Panel Recommendations

“…Modern patches tend to consist of a sheet-like backing and a self-adhering surface. Fibrin patches (TachoSil, Evarrest) and synthetic or protein-reactive sealant patches (Hemopatch, Veriset) are commonly used [ 61 ]. Polysaccharide patches (Heamocer patch) are also available which dehydrate the blood to concentrate clotting agents locally [ 62 ].…”