Use of MPH hemostatic powder for electrophysiology device implantation reduces postoperative rates of pocket hematoma and infection

Reynbakh, Olga; Akhrass, Philippe; Souvaliotis, Nektarios; Pamidimukala, Chaithanya K; Nahar, Hasnun; Bastawrose, Joseph; Boktor, Pierre; Aziz, Joshua E; Mehta, Davendra; Aziz, Emad F.

doi:10.1080/03007995.2018.1476847

Cited by 10 publications

(7 citation statements)

References 31 publications

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“…Having ulcers larger than 1.5 cm in diameter is considered a risk factor for rebleeding, however (Jung et al., 2023). Polysaccharide‐based powders also featured by less postoperative complications and infections compared to other haemostatic powders in two studies investigating their use in abdominal and pelvic surgery as well as cardiac implantable electronic device implantation (O'Hanlan & Bassett, 2022; Reynbakh et al., 2018). Besides rebleeding, no serious side effects are reported in association with the use of SH powder (migration, foreign body reactions, compression and damage of tissues; Schmitz & Sodian, 2015).…”

Section: Discussionmentioning

confidence: 99%

Intraluminal administration of a carboxymethyl‐starch powder for bladder haemorrhage treatment in two adult horses

Memoli,

Fontana,

Basano

et al. 2024

Equine Veterinary Education

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SummaryInternal bleeding and mucosal bleeding in hollow organs are uncommon conditions in equine medicine and endoscopy. Most of the time, they respond to treatment of the underlying primary condition. However, there are cases in which a rapid and effective control of blood loss is required and the animal is not suited for surgery or general anaesthesia. We report two cases referred to our Veterinary Teaching Hospital with signs of urinary disease and bladder haemorrhage identified by cystoscopy which were successfully managed with topical application of a haemostatic carboxymethyl‐starch powder. The product was applied directly on the bleeding mucosa after bladder emptying either under endoscopic guidance or blindly, through a urinary catheter. The application of the haemostatic powder appears to be easy to perform, safe and helpful in controlling mucosal bleeding in hollow organs in a short time, with no adverse reactions noticed. This approach should be considered in cases where mucosal bleeding can be identified by endoscopy and a prompt control of blood loss is required, also in the field.

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Section: Discussionmentioning

confidence: 99%

Intraluminal administration of a carboxymethyl‐starch powder for bladder haemorrhage treatment in two adult horses

Memoli,

Fontana,

Basano

et al. 2024

Equine Veterinary Education

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“…Since the drainage effect of iNPWT alone was limited to the superficial layer of the sutured wound, hematoma formation and subsequent wound dehiscence was inevitable. Hematoma is one of the most important risk factors for SSI 34,35) . Therefore, we recognized the need for additional preventive measures against hematoma formation.…”

Section: Discussionmentioning

confidence: 99%

Incisional Negative Pressure Wound Therapy with Reinforcement of Subcutaneous Drainage (Hybrid-iNPWT)

Kitano

Kitagawa²,

Taniguchi³

et al. 2021

International Journal of Surgical Wound Care

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Introduction: Incisional negative pressure wound therapy (iNPWT) is a preventive measure for postoperative wound dehiscence in which negative pressure is applied to the suture wound. Indeed, insufficient drainage in the deep layer is associated with an increased risk of developing subcutaneous hematoma and wound complications. Here, we report two cases of lower limb degloving injury successfully managed by iNPWT, with the reinforcement of subcutaneous drainage (hybrid-iNPWT). Case presentation: Case 1 was that of an 87-year-old man who sustained a deep, dissecting hematoma of the left lower leg associated with the sensation of severe tightness and pain. After emergency incision and removal of the hematoma in the deep fascia, we performed a primary closure of the flap wound. A negative pressure of 80 mmHg was applied to the sutured wound via foam dressing (iNPWT). Concurrently, we connected the negative pressure device with a subcutaneous drainage tube inserted under the flap (hybrid-iNPWT). The flap survived without recurrence of hematoma. Case 2 was that of an 89-year-old woman with a right lower leg degloving injury. The skin and subcutaneous tissues were detached from the underlying fascia. After primary closure of the flap, hybrid-iNPWT was performed at a subatmospheric pressure of 80 mmHg. The patient was discharged without any complications related to wound healing. Discussion: The aim of using hybrid-iNPWT was to apply negative pressure not only to the surface of the sutured wound but also to the posterior portion of the flap. The intensity of the negative pressure provided by the iNPWT device was higher than that of the conventional suction drainage tube system. Hybrid-iNPWT can be an alternative solution for hematoma prevention and may allow early ambulation in the management of lower limb degloving injuries in elderly patients.

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“…• Due to fast absorption (within 24 hours), Arista™ AH does not interfere with imaging 43 • It is associated with a minimal, if any inflammatory response 44 • The starch in the proprietary MPH technology does not exhibit starch crystallinity 45 • Arista™ AH powder is ready on demand to address diffuse surgical bleeding, with no preparation needed as an adjunct to conventional hemostasis 42 • Arista™ AH provides broad area coverage on rough surfaces and hard-to-reach areas when adjunctive hemostasis is required 2 • Complete hemostasis is achieved within minutes 46,47 • It is not associated with adhesion formation [48][49][50] • Safety and efficacy have been demonstrated across a variety of surgical areas, including general surgery, obstetrics/ gynecology, urology, cardiac, and orthopedic surgery 2,39,41,[51][52][53][54][55][56][57][58][59][60][61][62][63][64][65] However, it should be noted that some of this data was generated in preclinical models and may not correlate to performance in humans. Preclinical and clinical evidence supporting the use of MPH in a variety of surgical settings are detailed in the following sections.…”

Section: Advantages Of Arista Tm Ah Absorbable Hemostatic Particlesmentioning

confidence: 99%

Review of Evidence Supporting the Arista™ Absorbable Powder Hemostat

LyBarger

2024

MDER

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Background: Uncontrolled and diffuse bleeding is a dreaded event during open and laparoscopic surgery that may lead to postoperative complications, obstruction of the surgical field that reduces visualization, and prolonged operating times. Powder hemostats can be used to control bleeding and are easy to use, have a safe profile, and can achieve broad coverage area at a low cost. Methods: A strategic literature search of peer-reviewed, English language studies was conducted to capture evidence on the clinical efficacy and safety of a Microporous Polysaccharide Hemosphere (MPH) based Hemostat (Arista™ Absorbable Hemostat (Arista™ AH)). Results: Six preclinical studies were found which supported the use of MPH in various animal models of laparoscopic and open surgery, all of which demonstrated its safety and efficacy. Five single-arm and 11 comparative clinical studies similarly supported the efficacy and safety of MPH in various surgery types, including cardiac, renal, and dermatologic surgery. Conclusion: Published evidence supports the safe and effective use of MPH across a variety of surgical settings.

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Use of MPH hemostatic powder for electrophysiology device implantation reduces postoperative rates of pocket hematoma and infection

Cited by 10 publications

References 31 publications

Intraluminal administration of a carboxymethyl‐starch powder for bladder haemorrhage treatment in two adult horses

Intraluminal administration of a carboxymethyl‐starch powder for bladder haemorrhage treatment in two adult horses

Incisional Negative Pressure Wound Therapy with Reinforcement of Subcutaneous Drainage (Hybrid-iNPWT)

Review of Evidence Supporting the Arista™ Absorbable Powder Hemostat

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