Different Uses of Chitosan for Treating Serious Obstetric Hemorrhages

Carles, Gabriel; Dabiri, Clément; Mchirgui, Ali; Saoudi, El Oula; Hcini, Najeh; Seve, Beatrice; Matteis, Bruno de

doi:10.17140/goroj-3-129

Cited by 3 publications

(4 citation statements)

References 13 publications

(9 reference statements)

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“…Similarly, there is increasing interest in the potential role of topical haemostatic agents such as Floseal and Chitosan in obstetric haemorrhage control but data on their use and efficacy are currently limited to case series. We have little experience in these agents and our manuscript focuses predominantly on the effect of physical tamponade using abdomino‐pelvic packing which is more readily available and learnt.…”

Section: Discussionmentioning

confidence: 91%

“…However, abdomino‐pelvic packing remains a valuable skill in the armamentarium of the modern obstetrician, as it is simple to perform using easily accessible material and has low complication rates. While particularly useful in low‐resource settings, packing is equally relevant in developed countries such as France, America and Japan, as this technique, when used judiciously, complements surgical interventions such as intrauterine balloon tamponade, compression sutures and selective vessel ligation. All obstetricians should be able to perform abdomino‐pelvic packing safely and effectively.…”

Section: Discussionmentioning

confidence: 99%

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Abdomino‐pelvic packing revisited: An often forgotten technique for managing intractable venous obstetric haemorrhage

Yoong

Lavina

Ali

et al. 2018

Aust NZ J Obst Gynaeco

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Postpartum haemorrhage (PPH) remains the leading cause of maternal mortality worldwide, contributing to more than two-thirds of peripartum deaths, especially in developing countries. 1 This obstetric emergency requires timely recognition and management, as the overwhelming majority of deaths due to uncontrolled PPH occur within four hours of delivery. Surgical interventions such as intrauterine balloon tamponade, 2 compression sutures 3,4 and selective devascularisation (including internal iliac artery Background: Surgical packing should not be seen as a 'bail out' for the less skilled obstetrician who is unable to control obstetric haemorrhage using conventional techniques. Rather, this should be considered in cases of coagulopathy or where haemorrhage persists from raw surfaces, venous plexuses and inaccessible areas. Materials and methods: Data from seven women who underwent abdominopelvic packing for intractable postpartum bleeding were collected. The primary outcome was success of intra-abdominal packing and secondary outcomes included estimated blood loss, units transfused, length of stay and postoperative complications.Results: All seven women (median age 39 years, interquartile range (IQR) 3.25) had caesarean section deliveries with median estimated blood loss of 5521.4 mL (IQR 4475) and median of 6.9 (IQR 4.75) units transfused. Abdomino-pelvic packing was successful in all cases including in three women who had continued bleeding after peripartum hysterectomy. In the remaining four, bleeding stopped with packing, enabling the uterus to be conserved. The median number of packs inserted was 6.1 (IQR 4.2) and median shock index at time of decision to pack was 0.98 (IQR 0.13). The median pack dwell time was 30.8 h (IQR 24), while median length of stay following removal was 48 h (IQR 2.14). Conclusion:Intractable bleeding in these seven cases was successfully controlled by abdomino-pelvic packing, allowing supportive correction of hypothermia, tissue acidosis, coagulopathy and hypovolemia. The technique of packing is an essential skill in managing massive obstetric haemorrhage, in addition to uterine balloon tamponade, compression sutures and peripartum hysterectomy. K E Y W O R D S coagulopathy, obstetric hysterectomy, packing, postpartum haemorrhage

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Abdomino‐pelvic packing revisited: An often forgotten technique for managing intractable venous obstetric haemorrhage

Yoong

Lavina

Ali

et al. 2018

Aust NZ J Obst Gynaeco

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“…Bei intrauteriner Tamponade ist die Anwendung einer mit einer hämostatischen Komponente (Chitosan) beschichteten und für die Notfall- bzw. Militärmedizin entwickelten Gaze (Celox) im Management der PPH in mehreren Fallserien beschrieben und sollte – insbesondere bei Antikoagulation – vor einer reinen Gaze-Tamponade bevorzugt werden 116 , 117 , 118 . Im November 2022 wurde vom Hersteller bekannt gegeben, dass mit „Celox PPH“ eine spezielle Variante von Celox die CE-Zertifizierung erhalten hat.…”

Section: Leitlinieunclassified

Peripartum Haemorrhage, Diagnosis and Therapy. Guideline of the DGGG, OEGGG and SGGG (S2k, AWMF Registry No. 015-063, August 2022)

Schlembach

Annecke

Girard

et al. 2023

Geburtshilfe Frauenheilkd

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Aim This official guideline was coordinated and published by the German Society of Gynaecology and Obstetrics (DGGG). The guideline aims to provide a consensus-based overview of the diagnosis and management of peripartum bleeding based on an evaluation of the relevant literature. Methods This S2k-guideline was developed by representative members from different medical professions on behalf of the guidelines commission of the DGGG, OEGGG and SGGG using a structured consensus process. Recommendations Recommendations for the definition, risk stratification, prevention, treatment (general emergency procedures, medications, uterine tamponade, surgical measures, interventional-radiological procedures, haemostasis, and coagulation management), transportation, documentation and debriefing as well as training are presented. In addition, a PPH algorithm for action, “PPH 2022”, is recommended.

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“…Гемо-статический материал на основе хитозана зареко-мендовал себя как средство надежного, быстрого, безопасного гемостаза в полевых испытаниях в Афганистане, как на поле боя, так и в операцион-ной [10], а также может найти применение в каче-стве гемостатического средства во время операции. Имеются сведения об успешном использовании хитозана в гинекологической и кардиохирургиче-ской практике при массивных травматичных опе-рациях с предполагаемой большой кровопотерей [11]. В моделировании травмы печени на крупных биологических объектах, при тампонаде печени бинтом с хитозаном гемостатический бинт плотно фиксируется к раневой поверхности печени и не вызывает контактных повреждений органов брюш-ной полости.…”

Section: Original Researches оригинальные исследованияunclassified

Новий Гемостатичний Бинт На Основі Природного Біополімеру Хітозану

Феськов¹,

Sokolov²,

Soloshenko³

2022

ЕМ

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Кровотеча смертельно небезпечна. Проведення екстреного, ефективного гемостазу є основним завданням при наданні допомоги як у мирному житті, так і в період військових конфліктів. Тому догоспітальна гемостатична допомога повинна надаватися в найкоротший термін. Ефективний гемостатичний матеріал повинен бути доступним в екстреній ситуації, легко наноситися і надійно контролювати кровотечу з великих судин. Таким рішенням може стати вітчизняний гемостатичний бинт на нетканій основі з хітозаном Revul®, який відповідає всім вимогам, що висуваються до даних матеріалів. Гемостатика на основі хітозану при зупинці масивних кровотеч відноситься до першої медичної допомоги за класифікацією НАТО. Тому гемостатичний бинт на хімічній основі (хітозан та ін.), згідно з інструкціями з догляду за пораненими на тактичному рівні (ТССС — Tactical Combat Casualty Саrе, 2009 р.), керівництвом з інтенсивної терапії при травмі на догоспітальному етапі в районі бойових дій (BATLS — Battlefild Advanced Trauma Life Support), включений у сучасну аптечку стандарту НАТО як обов’язковий компонент.

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Different Uses of Chitosan for Treating Serious Obstetric Hemorrhages

Cited by 3 publications

References 13 publications

Abdomino‐pelvic packing revisited: An often forgotten technique for managing intractable venous obstetric haemorrhage

Abdomino‐pelvic packing revisited: An often forgotten technique for managing intractable venous obstetric haemorrhage

Peripartum Haemorrhage, Diagnosis and Therapy. Guideline of the DGGG, OEGGG and SGGG (S2k, AWMF Registry No. 015-063, August 2022)

Новий Гемостатичний Бинт На Основі Природного Біополімеру Хітозану

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