Evaluation of Hemostatic Agents for Skin Graft Donor Sites

Carucci, Daniel J.; Pearce, R.Scott C.; Innes, Donald J.; Rodeheaver, George T.; Kenney, John G.; Edlich, Richard F.

doi:10.1097/00004630-198407000-00015

Cited by 4 publications

(6 citation statements)

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“…and Netscher et al . demonstrated that topical vasopressors decreased the amount of bleeding and time of bleeding from donor/graft sites . More recently, Barrett et al .…”

Section: Blood Conserving Techniquesmentioning

confidence: 94%

“…In Australia, only human plasma‐derived thrombin is available; however, both bovine (bThrombin) and recombinant (rThrombin) remain available overseas. Two studies in the 1980s compared bThrombin with adrenaline and phenylephrine, respectively, for donor site haemostasis and found vasopressors both more effective and more economical …”

Section: Blood Conserving Techniquesmentioning

confidence: 99%

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Medical management of paediatric burn injuries: Best practice part 2

D'Cruz

Martin

Holland

2013

J Paediatrics Child Health

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Burns remain a leading cause of injury in the paediatric population in Australia despite efforts in prevention. Advances in surgical management include novel debridement methods and blood conserving techniques. Patients with severe burns (>20%) remain significantly more complex to manage as a result of extensive alterations in metabolic processes. There appears increasing evidence to support the use of pharmacological modulators of the hyper-metabolic state in these patients. The management of a child with burns involves acute, subacute and long-term planning. This holistic approach seems optimally co-ordinated by a Burns Unit in which each discipline required to provide care to these children in order to achieve optimal outcomes is represented.

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“…and Netscher et al . demonstrated that topical vasopressors decreased the amount of bleeding and time of bleeding from donor/graft sites . More recently, Barrett et al .…”

Section: Blood Conserving Techniquesmentioning

confidence: 94%

Section: Blood Conserving Techniquesmentioning

confidence: 99%

Medical management of paediatric burn injuries: Best practice part 2

D'Cruz

Martin

Holland

2013

J Paediatrics Child Health

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“…Carucci et al reported that the amount of blood absorbed was significantly less from donor sites treated with phenylephrine than with thrombin (p < 0.05) [ 14 ]. We had no access to original data and therefore could not check this result.…”

Section: Comparison 1 Epinephrine Vs Thrombin (3 Trials)mentioning

confidence: 99%

“…Carucci et al reported costs for haemostatic treatment per patient was US$3 for treatment with phenylephrine, and US$92 for treatment with thrombin [ 14 ]. Both studies reported on direct costs without statistical analysis.…”

Section: Comparison 1 Epinephrine Vs Thrombin (3 Trials)mentioning

confidence: 99%

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Topical haemostatic agents for skin wounds: a systematic review

2011

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BackgroundVarious agents and techniques have been introduced to limit intra-operative blood loss from skin lesions. No uniformity regarding the type of haemostasis exists and this is generally based on the surgeon's preference. To study the effectiveness of haemostatic agents, standardized wounds like donor site wounds after split skin grafting (SSG) appear particularly suitable. Thus, we performed a systematic review to assess the effectiveness of haemostatic agents in donor site wounds.MethodsWe searched all randomized clinical trials (RCTs) on haemostasis after SSG in Medline, Embase and the Cochrane Library until January 2011. Two reviewers independently assessed trial relevance and quality and performed data analysis. Primary endpoint was effectiveness regarding haemostasis. Secondary endpoints were wound healing, adverse effects, and costs.ResultsNine relevant RCTs with a fair methodological quality were found, comparing epinephrine, thrombin, fibrin sealant, alginate dressings, saline, and mineral oil. Epinephrine achieved haemostasis significantly faster than thrombin (difference up to 2.5 minutes), saline or mineral oil (up to 6.5 minutes). Fibrin sealant also resulted in an up to 1 minute quicker haemostasis than thrombin and up to 3 minutes quicker than placebo, but was not directly challenged against epinephrine. Adverse effects appeared negligible. Due to lack of clinical homogeneity, meta-analysis was impossible.ConclusionAccording to best available evidence, epinephrine and fibrin sealant appear superior to achieve haemostasis when substantial topical blood loss is anticipated, particularly in case of (larger) SSGs and burn debridement.

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