Evaluation of Microporous Polysaccharide Hemospheres as a Novel Hemostatic Agent in Open Partial Nephrectomy: Favorable Experimental Results in the Porcine Model

Murat, François-Joseph; Ereth, Mark H.; Dong, Yue; Piedra, Mark P.; Gettman, Matthew T.

doi:10.1097/01.ju.0000136001.99920.97

Cited by 67 publications

(63 citation statements)

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“…While the powder did occasionally spill into the abdominal cavity, this did not limit visibility and, because of its reported rapid absorption, would not be expected to be a problem. 13 Because MPH is derived from a plant source, the risk of disease transmission or allergic reaction is minimal. The readily available source provides a means to keep the overall cost of production low.…”

Section: Humphreys Et Al 1378mentioning

confidence: 99%

“…13,29,30 Our goal was to examine the efficiency of MPH in the laparoscopic setting for renal parenchymal injuries. The material worked very rapidly and was able to achieve hemostasis in all of our test lesions in less than 4 minutes.…”

Section: Humphreys Et Al 1378mentioning

confidence: 99%

“…14 The MPH-enhanced clot is enzymatically broken down into small water-soluble fragments, leaving no trace or radiographic evidence of deployment within 12 hours of application. 13,14 The purpose of this experiment was to determine the effectiveness of MPH in the intracorporeal laparoscopic environment for trocar injury to the renal parenchyma and to test the usefulness of a new, specially designed laparoscopic applicator.…”

Section: Introductionmentioning

confidence: 99%

“…13 The particles act as molecular sieves that selectively absorb water and low molecular weight compounds from the blood and concentrate clotting factors and platelets on the surface, thereby, accelerating the natural clotting cascade (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Humphreys Et Al 1378mentioning

confidence: 99%

Section: Humphreys Et Al 1378mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…In literature, however, some adverse events for hemostatic agents have been described, such as, wound infection, edema, nerve entrapment, allergic reaction [14] and misleading appearance on postoperative imaging [28]. The haemostatic effect of PerClot ® has been proven [29] and until now no adverse events occur using PerClot ® . The results of the present study are not contradictory of these findings but confirm the assumption of complication-free use of polysaccharide particles.…”

Section: Discussionmentioning

confidence: 99%

Comparison of an Intraoperative Application of a Haemostatic Agent (PerClot<sup>&reg</sup>) with Conventional Haemostatic Procedure after Thyroid Resection

Ahnen¹,

Ahnen²,

Wirth³

et al. 2015

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Background: Postoperative hemorrhage remains an uncommon but potentially life-threatening complication of thyroid surgery. The aim of this case-controlled study was to compare the effectiveness of PerClot ® hemostatic agent with hemostasis by conventional technique (HCT) in thyroid surgery. Methods: The thyroid resection was performed from November 2009 to February 2010. Exclusion criteria were applied. There were 30 patients in the HCT group and 30 patients in the PerClot ® group. The outcome parameters were postoperative bleeding, the drainage volume 24 hours postoperatively and adverse events according to PerClot ® . Results: There was no postoperative hemorrhage in both groups. We found no significant difference between the control and PerClot ® group with regard to total drainage volume after 24 h (51 ml ± 36.9 control group/53 ml ± 39.5 PerClot ® group (p = 0.79)). There were no adverse events in the PerClot ® group. Conclusions: Routine use of PerClot ® hemostatic agent has no advantage over conventional hemostasis technique (HCT) in thyroid surgery. In addition, PerClot ® is safe and well tolerated.

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Hemoadhican, a Tissue Adhesion Hemostatic Material Independent of Blood Coagulation

Kong

Chen

Wang

et al. 2023

Adv Healthcare Materials

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Uncontrolled hemorrhage is a leading cause of death, emphasizing the need for novel hemostatic agents. Here, a novel hemostatic polysaccharide hemoadhican (HD) is screened out by analyzing the rheological properties of screened material mixed blood sludges, which is prepared by mixing polysaccharide granules and whole blood to mimic the coagulation in vitro. HD is produced by a bacterial isolate Paenibacillus sp.1229, and the repeating units of HD are →)‐α‐L‐Rhap‐(1→3)‐β‐D‐Glcp‐(1→4)[4,6‐ethylidene‐α‐D‐Galp‐(1→4)‐α‐D‐Glcp‐(1→3)]‐α‐D‐Manp‐(1→. Compared to chitosan and celox, HD achieves more effective hemostasis in animal models with mouse and rat femoral arteries, rat carotid arteries, and rabbit femoral arteries. Especially, HD maintains an excellent hemostatic capability in animals with heparin‐induced hemorrhage diathesis. In vitro experiments show HD granules can quickly absorb a small amount of blood component to create a hemophobic blood sludge resistant to high pressure. The blood sludge firmly adheres to damaged tissue and efficiently repels blood. In vitro experiments show that HD does not actively trigger blood coagulation cascade and is independent of blood conditions including heparin treatment. In addition, HD moisturizes wounds and accelerates wound healing, exhibiting excellent biodegradability, and hemocompatibility. The results indicate that HD is a promising hemostatic material for treating traumatic hemorrhages and uncontrollable surgical bleeding.

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Evaluation of Microporous Polysaccharide Hemospheres as a Novel Hemostatic Agent in Open Partial Nephrectomy: Favorable Experimental Results in the Porcine Model

Abstract: MPH provided rapid, effective and durable hemostasis in the porcine open partial nephrectomy model. Additional experimental and clinical evaluation is warranted to define the role of MPH assisted partial nephrectomy in humans.

Cited by 67 publications

References 11 publications

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

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

Comparison of an Intraoperative Application of a Haemostatic Agent (PerClot<sup>&reg</sup>) with Conventional Haemostatic Procedure after Thyroid Resection

Hemoadhican, a Tissue Adhesion Hemostatic Material Independent of Blood Coagulation

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Evaluation of Microporous Polysaccharide Hemospheres as a Novel Hemostatic Agent in Open Partial Nephrectomy: Favorable Experimental Results in the Porcine Model

Abstract: MPH provided rapid, effective and durable hemostasis in the porcine open partial nephrectomy model. Additional experimental and clinical evaluation is warranted to define the role of MPH assisted partial nephrectomy in humans.

Cited by 67 publications

References 11 publications

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

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

Comparison of an Intraoperative Application of a Haemostatic Agent (PerClot&lt;sup&gt;&amp;reg&lt;/sup&gt;) with Conventional Haemostatic Procedure after Thyroid Resection

Hemoadhican, a Tissue Adhesion Hemostatic Material Independent of Blood Coagulation

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Comparison of an Intraoperative Application of a Haemostatic Agent (PerClot<sup>&reg</sup>) with Conventional Haemostatic Procedure after Thyroid Resection