Era of Bloodless Surgery: Spotlights on Hemostasic Materials and Techniques

Park, Ji Won; Koh, Jae-Whoan

doi:10.7599/hmr.2018.38.1.3

Cited by 4 publications

(3 citation statements)

References 69 publications

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“…11 Sutureless thyroidectomy avoids leaving foreign bodies in the patient's body thus eliminating its complications, decreases the incidence of knot slippage, reduces the operative time by using one instrument in dissection, hemostasis, and cutting of tissues thus reducing patient's exposure to anesthesia, efficient in hemostasis decreasing intra-operative blood loss and safe, reducing postoperative drainage volume, provide a clean surgical field, and showed greater capability of grasping delicate tissues, 1,[11][12][13] provides precise and safer dissection near vital structures due to minimal lateral thermal tissue injury, a smaller incision can be used in thyroid surgery using HS, provides smoke-less surgery, no electrical energy to or through patient, less charring, desiccation, and tissue sticking and no neuromuscular stimulation when compared to electrocautery, increases the utility of the operating rooms, means that more patients can be managed, decreases post-operative use of analgesics in comparison to conventional technique, decreases the incidence of post-operative hypocalcemia, decreases the incidence of lymphorrea caused by dissection and ligations allowing shortening of the hospital stay, and decreases the costs collectively. [13][14][15][16][17][18][19] In the meantime, post-operative thyroid specimens excised by HS are easily evaluated histopathologically. 20 But it has its own disadvantages including the cost of device and availability limitations in some areas.…”

Section: Introductionmentioning

confidence: 99%

Total thyroidectomy: conventional suture ligation technique versus sutureless techniques

et al. 2019

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Background: Since the introduction of successful thyroidectomy no change occurred in the technique but with the innovation of sutureless surgery, sutureless thyroidectomy becomes a competitor for the conventional technique. In this study we tried to analyze the outcomes of each.Methods: This was a prospective cross armed uncontrolled randomized study included 65 patients suffering from non-malignant goiter who underwent total thyroidectomy, admitted to Sohag University Hospital from September 2017 to October 2018. Patients were randomly allocated into two groups; Group (S) managed with sutureless thyroidectomy, and Group (C) managed with conventional knot tying technique. The data of the patients were gathered and analyzed considering the operative and post-operative outcomes. All patients were followed-up for 6 -12 months.Results: We found a significantly shorter operative time (p=0.001), also the amount of intra-operative blood loss was highly significant less in Group S (p=0.001). There was higher incidence of post-operative pain in Group C (p<0.001), post-operative drainage volume was highly significantly less in Group S (p=0.001). Regarding post-operative complications; the incidence of recurrent laryngeal nerve paralysis (RLNP) was insignificant between both groups (p=0.38), in the same time the incidence post-operative transient hypocalcaemia was significantly more in Group C (P=0.025). The overall post-operative complication rate was significantly more in Group C (p=0.002). The duration of hospital stay was highly significant shorter in Group S (p=0.0001).Conclusions: The use of Harmonic FOCUS® is beneficial for both patient and surgeon; it is efficient and a trustable safe substitute to the conventional knot tying technique.

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Section: Introductionmentioning

confidence: 99%

Total thyroidectomy: conventional suture ligation technique versus sutureless techniques

et al. 2019

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“…It is an inert material and dissolves from the bone within 48 hours after application and it is excreted from the body unchanged through renal clearance safely without metabolism. [11][12][13][14][15][16] Ostene® is applied in a similar fashion as bone wax and to a thickness of 1-2mm; it does not cause infection, nor induce inflammatory reactions, and it does not interfere with coagulation, nor with osseous union. [14][15][16][17][18] AOC have a long history of use in the medical and pharmaceutical field, its approved by the U.S Food and Drug Administration, it dissolves from the site of application faster than other materials, and it is also hypothesized that AOC permits faster bone healing than other resorbable hemostatic agents.…”

Section: Introductionmentioning

confidence: 99%

“…19,20 Ostene® may be a better alternative to bone wax due to its water solubility. 13,21 Bone wax is a well-known topical hemostatic agent, composed of cera alba (beeswax) (88%) and isopropyl palmitate (12%), a palm oil-based emollient, moisturizer, and thickening and anti-static agent. [22][23][24][25] Bone wax is relatively easy to use, and its application is very simple.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Ostene® and Bone wax on Bone Healing: A Comparative experimental study in rabbits.

Salim

2018

J Oral Res

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Introduction: Ostene® is a new synthetic bone hemostatic waxlike inert and biocompatible material that dissolves within two days after application. Bone wax is a well-known topical hemostatic agent, easy to use, and its application is very simple. Wound healing is a complex biological process; Bone is a dynamic tissue that is continuously resorbed, renewed, and remodeled. Materials and methods: Twenty domestic rabbits were divided into four groups (day 1, day 3, day 7, and day 14). Each rabbit was anaesthetized and three holes were drilled in the mandible: one was filled with Ostene®, another with bone wax, and the other was left unfilled as control. Sites of intervention were assessed by histopathology. Results and Discussion: Ostene® and bone wax showed osteoinductive property in bone healing with no inflammatory reaction. Our study revealed new bone formation within 14 days in Ostene® group. After histopathological analysis and scoring was finished, analysis by SPSS 14 software showed a significant difference between the use of Ostene® and bone wax. Conclusion: Ostene® showed superiority over bone wax in bone healing, and it can be used in the same way as bone wax with no interference with bone healing and osteogenesis. Ostene® has no side effects following application.

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Principles of minimize bleeding and the transfusion of blood and its components in operated patients – surgical aspects

Banasiewicz,

Machała,

Borejsza Wysocki

et al. 2023

Pol Przegl Chir

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One of the target of perioperative tratment in surgery is decreasing intraoperative bleeding, which increases the number of perioperative procedures, mortality and treatment costs, and also causes the risk of transfusion of blood and its components. Trying to minimize the blood loss(mainly during the operation) as well as the need to transfuse blood and its components (broadly understood perioperative period) should be standard treatment for a patient undergoing a procedure. In the case of this method, the following steps should be taken: 1) in the preoperative period: identyfication of risk groups as quickly as possible, detecting and treating anemia, applying prehabilitation, modyfying anticoagulant treatment, considering donating one's own blood in some patients and in selected cases erythropoietin preparations; 2) in the perioperative period: aim for normothermia, normovolemia and normoglycemia, use of surgical methods that reduce bleeding, such as minimally invasive surgery, high-energy coagulation, local hemostatics, prevention of surgical site infection, proper transfusion of blood and its components if it occurs; 3) in the postoperative period: monitor the condition of patients, primarily for the detection of bleeding, rapid reoperation if required, suplementation (oral administration preferred) nutrition with microelements (iron) and vitamins, updating its general condition. All these activities, comprehensively and in surgical cooperation with the anesthesiologist, should reduce the blood loss and transfusion of blood and its components.

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Era of Bloodless Surgery: Spotlights on Hemostasic Materials and Techniques

Cited by 4 publications

References 69 publications

Total thyroidectomy: conventional suture ligation technique versus sutureless techniques

Total thyroidectomy: conventional suture ligation technique versus sutureless techniques

Comparison of Ostene® and Bone wax on Bone Healing: A Comparative experimental study in rabbits.

Principles of minimize bleeding and the transfusion of blood and its components in operated patients – surgical aspects

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