Comparison of a New Fibrin Sealant With Standard Topical Hemostatic Agents

Schwartz, Myron; Madariaga, Juan; Hirose, Ryutiao; Shaver, Timothy R.; Sher, Linda; Chari, Ravi S.; Colonna, John O.; Heaton, Nigel; Mirza, Darius F.; Adams, Reid B.; Rees, Myrddin

doi:10.1001/archsurg.139.11.1148

Cited by 141 publications

(116 citation statements)

References 17 publications

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“…38,39 Current scientific evidence suggests beneficial effects in reducing the time to hemostasis and in lowering the requirements for perioperative RBC transfusions. [39][40][41][42][43] Although the beneficial effects of fibrin sealants have also been confirmed in a recent Cochrane review, 44 the efficacy of fibrin sealant in liver surgery has recently been questioned. 45 In a large, randomized, controlled trial in 300 patients undergoing partial liver resection, Figueras and associates 45 found no difference in total blood loss, transfusion requirements, or postoperative morbidity between patients treated with fibrin sealants (n 5 150) and a control group without fibrin sealants (n 5 150).…”

Section: Topical Hemostatic Agentsmentioning

confidence: 99%

Bleeding in Liver Surgery: Prevention and Treatment

Alkozai

Lisman

Porte

2009

Clinics in Liver Disease

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Section: Topical Hemostatic Agentsmentioning

confidence: 99%

Bleeding in Liver Surgery: Prevention and Treatment

Alkozai

Lisman

Porte

2009

Clinics in Liver Disease

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“…15 Perhaps the largest impediment to this therapy in the acute laparoscopic setting, other than getting the material to the site of injury, is the prolonged preparation time of up to 40 minutes to reconstitute these products. 24 Matrix hemostats, such as FloSeal (Baxter Healthcare, Deerfield, IL), use a special bovine collagen gelatin matrix that is cross-linked by glutaraldehyde. 25 Like fibrin sealants, they require preparation with thrombin before application.…”

Section: Humphreys Et Al 1378mentioning

confidence: 99%

Renal Injury and the Application of Polysaccharide Hemospheres: A Laparoscopic Experimental Model

Humphreys

Lingeman

Terry

et al. 2008

Journal of Endourology

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Background and Purpose: Microporous polysaccharide hemospheres (MPH) are hemostatic beads engineered from purified plant starch. MPH accelerates the natural clotting cascade by concentrating clotting factors and proteins on their surface while absorbing aqueous and low molecular weight components from blood. The purpose of this study was to determine the efficacy of MPH in achieving hemostasis in the setting of laparoscopic renal injury. Materials and Methods:In four domestic pigs, 16 laparoscopic renal trocar injuries were created (8 each of 12 and 5 mm). A standard hand-assisted laparoscopic approach was used to each kidney so that two lesions per kidney were randomly created. MPH was applied to each treatment lesion with light pressure maintained for 60 seconds. Four of the 16 lesions, two each of 12 and 5 mm, were allowed to bleed as controls. Hemostasis was defined as no active bleeding or oozing. The animals were sacrificed at the conclusion of the procedure. Results: The mean time to hemostasis for the 12-mm MPH and control lesions was 196.2 Ϯ 53.3 and 372.0 Ϯ 225.6 seconds, while the average blood loss was 8.3 Ϯ 3.7 and 12.0 Ϯ 4.9 g, respectively. For the 5-mm MPH and control lesions, the average time to hemostasis was 100.2 Ϯ 24.8 and 247.0 Ϯ 134.4 seconds, while the average blood loss was 8.3 Ϯ 3.8 and 9.0 Ϯ 0.7 g, respectively. The median number of applications of the MPH for the 5-and 12-mm injuries was 1 and 2, respectively. Conclusions: MPH provided a rapid and effective means of hemostasis for laparoscopic renal parenchymal injuries in this model. Additional evaluation is warranted, however, before general application is advisable.

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“…Karaciğer ve dalak cerrahisinde kullanımının kanama kontrolündeki etkisi gösteril-miştir. [9][10][11][12][13] Ankaferd Blood Stopper ® (ABS) son yıllarda klinik kullanıma giren, bitkisel kökenli, topikal hemostatik ajandır. Hemostazı, kanama pıhtılaşma faktörle-rinden bağımsız olarak, enkapsüle protein ağı ile fokal eritrosit agregasyonunu sağlayarak gerçekleştirir.…”

Section: Resultsunclassified

“…Ameliyat süresinin kısalması için, kanamanın kontrolünde topikal hemostatiklerin kullanımı da cerraha avantaj sağlayabilir Günümüz-de Japonya'da topikal hemostatiklerin karaciğer cerrahisinde standart bir endikasyon olmadan kullanımı %60'a kadar çıkmıştır. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Bu ajanların seçiminde cerrahın tercihi kadar, hemostatik materyalin yapısı, kanamanın ciddiyeti, acil ya da elektif cerrahi yaklaşımlar gibi faktörler oynar. Fiyat, uygulama kolaylığı ve muhafaza edilme özellikleri de seçimi etkilemektedir.…”

Section: Discussionunclassified