Efficacy and Safety of a Thrombin-Containing Collagen-Based Hemostatic Agent in Spinal Surgery: A Randomized Clinical Trial

Park, Sang Man; Kang, Dae Ryong; Lee, Jun Hyuk; Jeong, Yeong Ha; Shin, Dong Ah; Yi, Seong; Ha, Yoon; Kim, Keung Nyun

doi:10.1016/j.wneu.2021.07.012

Cited by 11 publications

(8 citation statements)

References 22 publications

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“…Thrombin plays a role in clot promotion and fibrin formation. TCLH induces hemostasis at the beginning and end of the coagulation cascade by promoting platelet activation and facilitating fibrin formation [ 8 ]. Although TCLH has a volume of 3 mL and a small hemostatic effect through physical compression, compression was routinely performed to increase the contact between the surgical area and TCLH whenever possible.…”

Section: Discussionmentioning

confidence: 99%

Effect of Thrombin-Containing Local Hemostatics on Postoperative Spinal Epidural Hematoma in Biportal Endoscopic Spinal Surgery

Ko,

Ahn,

Lee

et al. 2024

Asian Spine J

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Study Design: Retrospective case–control study.Purpose: This study aimed to investigate the preventive effect of thrombin-containing local hemostatics (TCLH) on postoperative spinal epidural hematoma (POSEH) in biportal endoscopic spinal surgery (BESS). This study compared the incidence of morphometric and symptomatic POSEH with or without TCLH in BESS.Overview of Literature: POSEH is reported not uncommon in BESS when compared with conventional spine surgery (CSS). TCLH achieves hemostasis with a high success rate in CSS. However, few studies have examined the effect of TCLH on BESS.Methods: Patients with and without TCLH were assigned to groups A and B, respectively. POSEH between the two groups was compared morphometrically and symptomatically. The risk factors for symptomatic and morphometric POSEH in BESS were identified.Results: The morphometric POSEH was greater in group B, and the difference was significant (p =0.019). The incidence of symptomatic POSEH was lower in group A with 4.6% (5/109) than in group B with 9.5% (9/95); however, the rate was not significantly different (p =0.136). The morphometric POSEH was classified into two small (hG1 and hG2) and large (hG3 and hG4) and were compared between groups A and B, and the difference was significant (p =0.02). In the multivariable logistic regression, nonuse of TCLH (p =0.004) and preoperative diagnosis of stenosis (p =0.016) were variables found to be significant risk factors of morphometric POSEH.Conclusions: Severe compression of the thecal sac by POSEH is more common in patients without TCLH. The risk of hematoma formation was higher when bilateral decompression was needed and the cut bone surface was more exposed.

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Section: Discussionmentioning

confidence: 99%

Effect of Thrombin-Containing Local Hemostatics on Postoperative Spinal Epidural Hematoma in Biportal Endoscopic Spinal Surgery

Ko,

Ahn,

Lee

et al. 2024

Asian Spine J

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“…88 However, this hemostatic material is originated from porcine or bovine, and should be used with caution in patients with allergies or contraindications. 89 Rafael et al prepared a novel nanostructured fibrin-agarose hydrogel patch, which showed greater hemostatic capacity than the commercially available prothrombin complex concentrate (PCC). The gel was fully absorbable and biodegradable, and had no tissue reactivity or antigenicity.…”

Section: Biological Hemostatic Materialsmentioning

confidence: 99%

“…Only one injection of fibrin glue was required to effectively stop bleeding in the cases of six patients . However, this hemostatic material is originated from porcine or bovine, and should be used with caution in patients with allergies or contraindications . Rafael et al prepared a novel nanostructured fibrin-agarose hydrogel patch, which showed greater hemostatic capacity than the commercially available prothrombin complex concentrate (PCC).…”

Section: Biological Hemostatic Materialsmentioning

confidence: 99%

Recent Advances in Topical Hemostatic Materials

Liu,

Zhang,

Yao

et al. 2024

ACS Appl. Bio Mater.

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Untimely or improper treatment of traumatic bleeding may cause secondary injuries and even death. The traditional hemostatic modes can no longer meet requirements of coping with complicated bleeding emergencies. With scientific and technological advancements, a variety of topical hemostatic materials have been investigated involving inorganic, biological, polysaccharide, and carbonbased hemostatic materials. These materials have their respective merits and defects. In this work, the application and mechanism of the major hemostatic materials, especially some hemostatic nanomaterials with excellent adhesion, good biocompatibility, low toxicity, and high adsorption capacity, are summarized. In the future, it is the prospect to develop multifunctional hemostatic materials with hemostasis and antibacterial and anti-inflammatory properties for promoting wound healing.

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“…Partial hydrolysis of collagen results in the production of gelatin, and it can be used to address (to a certain extent) the safety issues posed by collagen 100 . Gelatin has been processed in various forms for clinical applications, and the most commonly used gelatin-based material for hemostasis is the gelatin sponge 101 , 102 . Slezak et al compared the hemostatic effects exerted by the collagen and thrombin-containing powder agent Hemoblast® and the flowable gelatin-thrombin matrix Floseal® in a porcine liver hemorrhage model.…”

Section: Introductionmentioning

confidence: 99%

Recent advances in the medical applications of hemostatic materials

Yu¹,

Wang²,

Liu³

et al. 2023

Theranostics

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Bleeding caused by trauma or surgery is a serious health problem, and uncontrollable bleeding can result in death. Therefore, developing safe, effective, and convenient hemostatic materials is important. Active hemostatic agents currently used to investigate the field of hemostasis are divided into four broad categories: natural polymers, synthetic polymers, inorganic materials, and metal-containing materials. Hemostatic materials are prepared in various forms for wound care applications based on the active ingredients used. These materials include nanofibers, gels, sponges, and nanoparticles. Hemostatic materials find their applications in the field of wound care, and they are also used for hemostasis during malignant tumor surgery. Prompt and effective hemostasis can reduce the possibility of the spread of tumor cells with blood. This review discusses the outcomes of current research conducted in the field and the problems persisting in the field of developing hemostatic materials. The review also presents a platform for the further development of hemostatic materials. Bleeding caused by trauma or surgery is a serious health problem, and uncontrollable bleeding can result in death. Therefore, developing safe, effective, and convenient hemostatic materials is important. Active hemostatic agents currently used to investigate the field of hemostasis are divided into four broad categories: natural polymers, synthetic polymers, inorganic materials, and metal-containing materials. Hemostatic materials are prepared in various forms for wound care applications based on the active ingredients used. These materials include nanofibers, gels, sponges, and nanoparticles. Hemostatic materials find their applications in the field of wound care, and they are also used for hemostasis during malignant tumor surgery. Prompt and effective hemostasis can reduce the possibility of the spread of tumor cells with blood. This review discusses the outcomes of current research conducted in the field and the problems persisting in the field of developing hemostatic materials. The review also presents a platform for the further development of hemostatic materials.

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Efficacy and Safety of a Thrombin-Containing Collagen-Based Hemostatic Agent in Spinal Surgery: A Randomized Clinical Trial

Cited by 11 publications

References 22 publications

Effect of Thrombin-Containing Local Hemostatics on Postoperative Spinal Epidural Hematoma in Biportal Endoscopic Spinal Surgery

Effect of Thrombin-Containing Local Hemostatics on Postoperative Spinal Epidural Hematoma in Biportal Endoscopic Spinal Surgery

Recent Advances in Topical Hemostatic Materials

Recent advances in the medical applications of hemostatic materials

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