Topical Haemostatics in Renal Trauma—An Evaluation of Four Different Substances in an Experimental Setting

Björses, Katarina; Holst, Jan

doi:10.1097/ta.0b013e3181823533

Cited by 22 publications

(14 citation statements)

References 38 publications

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“…In a study by Bjö rses and Holst [8], MPH had a 20% (3 of 15) success rate to treat a rodent partial nephrectomy model heparinized to correct for interspecies variation. Ersoy et al [5] and Neuffer et al [22] have also reported that MPH is not effective in severe bleeds.…”

Section: Discussionmentioning

confidence: 98%

“…The limitation of our study is that the hemostatic agents were only compared in one tissue type. To address this, Bjö rses and Holst [8] compared MPH and hemostatic matrix in a rodent partial nephrectomy model, in which MPH provided a hemostatic success rate of 20% and hemostatic matrix provided 100% success rate. Although a small sample size was used by Bjö rses, the efficacy differences agree between the animal models.…”

Section: Discussionmentioning

confidence: 99%

“…Each animal was heparinized to at least two times greater than their baseline activated clotting time to mimic the clinical situation throughout the study. This level of heparinization gives a clinically relevant activated clotting time of !200 s [8].…”

Section: Heparinized Porcine Hepatic Abrasion Modelmentioning

confidence: 96%

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Efficacy of hemostatic matrix and microporous polysaccharide hemospheres

Lewis

Atlee

Mannone

et al. 2015

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Efficacy of hemostatic matrix and microporous polysaccharide hemospheres

Lewis

Atlee

Mannone

et al. 2015

Journal of Surgical Research

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“…18 However, MS is still insufficient to stem larger bleeds. 21 It is well accepted that hemostatic materials can be divided into passive or active hemostatic agents or combinations thereof. 22 Only active hemostatic agents can stop larger bleeds, which activate the blood coagulation system and accelerate the fibrin formation process, thereby facilitating the rapid creation of a strong hemostatic clot.…”

Section: Introductionmentioning

confidence: 99%

Calcium-modified microporous starch with potent hemostatic efficiency and excellent degradability for hemorrhage control

et al. 2015

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Effective hemorrhage control is vital for reducing mortality after major trauma both in civilian life and in the military. In recent years microporous starch (MS) has been used as a hemostatic agent. However, MS has an insufficient hemostatic capacity to stop severe bleeding. To improve its hemostatic performance, in this study calcium-modified microporous starch (CaMS) was firstly developed via oxidization and selfassembly with calcium ions (Ca 2+ ) on MS, and the hemostasis efficiency and degradation behaviour were evaluated. The results showed that the carboxyl groups and Ca 2+ had been modified successfully onto MS. MS and CaMS both initiated the hemostatic response by rapid absorption and swelling due to their porous structure and high surface area. It is noteworthy that CaMS activated an intrinsic pathway of coagulation cascade and induced platelet adhesion because of the modified Ca 2+ and carboxyl groups.The synergistic effects of the chemical activation mechanism and physical absorption mechanism resulted in a dramatic improvement in the hemostatic capacity of CaMS, and thus achieved an effective hemorrhage control in rabbit liver and femoral artery injuries. Additionally, the degradation of CaMS was improved greatly by the modification. In conclusion, CaMS effectively improved hemostatic performance and degradability. CaMS is a promising candidate for designing hemostatic agents in more extensive clinical applications.

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“…As it should be hard to conduct clinical trials on the use of HAs in several different surgical fields due to the individual variability of patients, there are not defined indications as regard their efficacy and safety and about how to choose the appropriate haemostatic. Several studies have been carried on to investigate the haemostatic capacity and stability of different HAs like gelatin (sponge and matrix), bovine thrombin, freeze-dried recombinant factor VIIa and microporous polysaccharide hemispheres, in experimental traumatic bleeding models) [13]. The reduction in blood loss after liver injury and in a grade 5 renal injury, with no delayed bleeding and nephrotoxicity, suggests a possible employ for FloSeal in the treatment of devastating renal injuries [14,15].…”

Section: Discussionmentioning

confidence: 99%

Haemostatics in surgery and our experience in the enucleoresection of renal cell carcinoma

et al. 2010

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Background30 patients, with T1 renal cell carcinomas (RCC) who underwent open enucleoresection of the tumour, were randomized to the use of a topical haemostatic agent (Floseal) or to an infrared-sapphire coagulator (ISC), to compare their efficacy in achieving haemostasis. Methods: Successful intra-operative haemostasis, intra- and post-operative bleeding, operative time, hospital discharge were evaluated.ResultsStatistically higher rates of successful haemostasis and shorter time-to-haemostasis (8,1 vs 12,9 min) were observed in the FloSeal group (p < 0.001 both). Patients operative time was not different between Group 1 vs 2 (58.7 ± 12 vs 62.4 ± 15; p > 0.05). The average blood loss during surgery was less (60 +/- 25.5 mL) for the FloSeal group than for the ISC group (85 +/- 40.5 mL) (p < 0.05). Postoperative blood loss was 25 +/- 5 mL and 40 +/- 45 mL for Floseal and ISC respectively, (p < 0.05). Length of the postoperative hospital discharge was 2.5 +/- 1.2 days for FloSeal group and 3.5 +/- 1.3 for the Group 2 (p < 0.05). No major immediate or delayed complications were observed in either Groups.ConclusionsThe use of Floseal and ISC offer a safe and efficacy haemostasis in the enucleoresection of RCC. Moreover, our results show a less intra-operative and post-operative blood loss as well as a shorter time to haemostasis of Floseal in respect to ISC.

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Topical Haemostatics in Renal Trauma—An Evaluation of Four Different Substances in an Experimental Setting

Abstract: Gelatin-containing products provided a fast hemostasis in this experimental model. One third of the animals rebled, regardless of whether thrombin or rFVIIa was added. Further studies are demanded to confirm these results clinically.

Cited by 22 publications

References 38 publications

Efficacy of hemostatic matrix and microporous polysaccharide hemospheres

Efficacy of hemostatic matrix and microporous polysaccharide hemospheres

Calcium-modified microporous starch with potent hemostatic efficiency and excellent degradability for hemorrhage control

Haemostatics in surgery and our experience in the enucleoresection of renal cell carcinoma

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