Validity of microporous polysaccharide hemispheres as a hemostatic agent in hepatic injuries: an experimental study in rats

Biondo-Simões, Maria de Lourdes Pessole; Petrauskas, Roberta; Dobrowolski, André Gustavo; Godoy, Giselle; Kaiber, Flávia; Ioshii, Sérgio Ossamu

doi:10.1590/s0102-86502007000700007

Cited by 8 publications

(4 citation statements)

References 19 publications

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“…They found similar inflammatory reactions in their two groups, but noted that in both groups the animals presented adhesions in the injured area 1 week after the operation. Biondo-Simões et al [18] also reported that the group in which CyA was applied to the liver parenchyma had the highest number of adhesions, coinciding with previous findings [41,42]. …”

Section: Discussionsupporting

confidence: 76%

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Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

Lloris‐Carsí

García-Cerdá²,

Prieto‐Moure³

et al. 2016

Eur Surg Res

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Background: Renal injuries are relatively frequent in abdominal trauma. In some cases, adhesives and sealants can be used to repair and preserve injured organs. This paper describes the behaviour of three biomaterials - TachoSil®, GelitaSpon®, and a new elastic cyanoacrylate (CyA), Adhflex® - in standardized experimental renal injuries. Methods: Ninety male Wistar rats (300-350 g) were used. A Stiefel Biopsy Punch (8 mm diameter, 3 mm depth) was used to create injuries to the anterior kidney to evaluate wound healing. The animals were divided into five groups: (1) sham (n = 3); (2) control (n = 6), untreated, standard punch injury created on the anterior left kidney; (3) TachoSil® (n = 27), punch injury treated with TachoSil®; (4) GelitaSpon® (n = 27), punch injury treated with GelitaSpon®, and (5) Adhflex® (n = 27), punch injury treated with the new elastic CyA adhesive. The parameters studied were bleeding time, peritoneal adhesions, and histopathological evaluation of wound healing on days 2, 6, and 18, including measurements of the gap between wound edges, inflammatory reaction (CD68), and vascular neoformation (CD31). Results: The bleeding time was significantly shorter (27.7 ± 12.9 s) in the Adhflex® group than in the control (135.8 ± 11.6 s; p < 0.01), TachoSil® (77.5 ± 7.4 s; p < 0.05), and GelitaSpon® (82.5 ± 14.4 s; p < 0.05) groups. The incidence of intraperitoneal adhesions in the animals treated with Adhflex® was 3.6 times higher than in the non-treated group. It was also higher (p < 0.04) than in the groups treated with TachoSil® and GelitaSpon®. The time point with the largest gap between the wound edges and most abundant granulation tissue was at day 6. The largest gap after 18 days was reported for the Adhflex® adhesive. With regard to the markers CD31 and CD68, Adhflex® showed the largest areas 2 days after surgery, but no differences were found after 6 and 18 days versus the other treatments. The expression of the immunomarkers on the renal samples treated with Adhflex® was consistent with a normal healing process. Conclusions: In this experimental model of renal injuries, the new elastic CyA (Adhflex®) resulted in the shortest bleeding time. It offers rapid sealing of the bleeding produced by renal injuries, fixation to adjacent tissues, and reduced occurrences of relapse. The evolution of the scarring is similar to other procedures. Given that traumatic renal injuries are always an emergency due to haemorrhage, Adhflex® might offer additional benefits over conventional treatment methods in human clinical practice.

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Section: Discussionsupporting

confidence: 76%

“…4 Gap between wound edges: the gap between wound edges was assessed following the method used by Biondo-Simões et al [18]. Briefly, the total area of the injury and the amounts of collagen and fibrin in the scar were measured using the microscope scanning software Pannoramic 250 Flash III (3DHISTECH Ltd., Budapest, Hungary).…”

Section: Methodsmentioning

confidence: 99%

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

Lloris‐Carsí

García-Cerdá²,

Prieto‐Moure³

et al. 2016

Eur Surg Res

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“…Although effective in hemorrhage control for low bleeding flows, 15,16 MS has shown an insufficient hemostatic capacity to stop larger and severe bleeds. [17][18][19][20] When combined with recombinant factor VIIa, evidence was found of an increased hemostatic effect. 18 However, MS is still insufficient to stem larger bleeds.…”

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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“…29,30 So far, it has been proven that many hemostatic agents, despite their good efficacy, have disadvantages such as systemic and local toxicity, heat damage, expensiveness, and tissue inflammation and adhesions, which limit their use. 3,31 Contrary to this, various studies demonstrated the positive role of PVA in biomedical uses, benefits of PVA such as biocompatibility, anti-inflammatory and antimicrobial properties are consequential and cannot be ignored even if PVA shows less efficacy than other hemostatic agents. 32,33 In our study in the same way with previous studies, no cytotoxic effects of PVA were observed.…”

Section: Holloway Et Al Represented a Direct Correlation Betweenmentioning

confidence: 99%

Biomedical properties and hemostatic efficacy of polyvinyl alcohol (PVA) based hydrogel in experimental rat liver injury model

Dorkhani,

Faryabi,

noorafkan

et al. 2023

Journal of Applied Biomaterials & Functional Materials

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Purpose: Bleeding is a leading cause of mortality and morbidity in the trauma and surgery field, using effective hemostatic agents can help us reduce bleeding especially in parenchymal hemorrhage. Nowadays polyvinyl alcohol (PVA) is known as a safe candidate for wound dressing and maybe a hemostatic agent. PVA-based hydrogel is a popular biocompatible material in the biomedical field especially when it has high water absorption. In this study, we investigated the PVA hydrogel’s mechanical and biological properties as well as its hemostatic potential in parenchymal bleeding. Methods: PVA hydrogel had made by the freeze-thawing approach, we used PVA hydrogel in comparison to standard treatment to investigate hemostatic potency. Also, we performed MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide) tests to survey PVA cellular toxicity. After an acute liver injury, two groups of 12 rats were treated with PVA hydrogel or standard treatment with sterile gauze. The results including the time and volume of bleeding, and the time and survival rate of the rats were measured and compared. Results: We saw that PVA hydrogel was safe with no cellular toxicity in the MTT assay. Regarding efficacy, PVA hydrogel increased rats’ survival after bleeding from 75% to 91.7%, and decreased bleeding time ( p: 0.015), and bleeding volume ( p: 0.03) compared to the control group. Conclusion: Polyvinyl alcohol is safe. It has good biological properties with no cellular toxicity and has a significant hemostatic effect and can be regarded in control of parenchymal hemorrhage.

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Validity of microporous polysaccharide hemispheres as a hemostatic agent in hepatic injuries: an experimental study in rats

Abstract: The MPH, despite achieving hemostasis, proved to be no more favorable than n-butyl-cyanoacrylate and the fibrin adhesive, the latter resulting in the lowest tissue reaction.

Cited by 8 publications

References 19 publications

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

Behaviour of the Biological Adhesives TachoSil®, GelitaSpon®, and a New Elastic Cyanoacrylate (Adhflex®) in Experimental Renal Trauma and Wound Healing

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

Biomedical properties and hemostatic efficacy of polyvinyl alcohol (PVA) based hydrogel in experimental rat liver injury model

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