In vitro Effect of a Microfibrillar Collagen Hemostat on Platelets

Abstract

Microscopic particles of microfibrillar collagen hemostat (MCH) have been shown to pass through a 40-μm blood transfusion filter. This study indicates that MCH passing through the filter retains a significant portion of its ability to aggregate platelets in vitro and the aggregating ability is dose related. The extent of platelet aggregation in the presence of the MCH filtrate or an ADP standard was measured photometrically and log dose-response curves constructed from the data. An ED₅₀ of 3.6 μg protein/ml platelet-rich plasma (PRP) was calculated at a protein concentration of 7.6 mg/ml in the MCH filtrate and an ED₅₀ of 5.9 μg protein/ml PRP at 12 mg/ml protein in the MCH filtrate. The platelet aggregating ability of the MCH filtrates corresponded to 18.8 and 39.6% of the maximum response produced by adenosine-5’-diphosphate. These findings support the view that blood contaminated with MCH should not be returned to a patient’s circulation.

Very low rate of patient‐related adverse events associated with the use of intraoperative cell salvage

“…Although overall ICS is a relatively safe procedure, it is not entirely without risk to patients. Various topical agents and surgical polymers utilized in the surgical field may cause patients to experience adverse reactions if they are inadequately removed from the salvaged blood during the wash step . Likewise, significant hypertension has been reported after ICS was performed on a patient with a pheochromocytoma, as the washing process does not always adequately remove the epinephrine and norepinephrine that can be collected if ICS is attempted in a patient with this type of tumor .…”

Reduction of Postoperative Haemorrhage with the Use of a Haemostatic Thrombin Matrix in Patients Who Underwent Decortication

“…Studies have revealed that THM has minimal antigenic properties and does not appear to be associated with a heightened risk of immune sensitization. 3,4 Collagen stimulates platelet aggregation, with platelets taking on an adhesive form in the presence of collagen, with the resulting plaque directly causing haemostasis and reducing haemorrhage at the application site. This relationship between platelets and collagen shortens the period of the intrinsic clotting by 60%.…”

“…21 The THM provides haemostasis during and after surgical operations 11,23 -26 and has been shown as clinically effective in 12 Furthermore, no complications or notable side-effects have been observed following THM use. 12 THM has also been used safely in the following procedures: cardiac surgery and in controlling diffuse haemorrhage; 3,5,27,28 in nerve surgery 29 in which haemostasis is difficult to achieve; in multiple skin graft studies; 13 and in patients with liver haemorrhage due to various aetiologies where quite successful haemostasis was achieved and minimal foreign tissue reaction was observed. 30 Successful use of THM has also been reported in orthopaedic surgery, 31 and it can be used effectively in emergency cases.…”

“…Thrombin-added haemostatic matrix (THM) is one of these methods and comprises sterile absorbable bovine gelatin that aids haemostasis when applied to the bleeding surface. 3,17,18 Use of THM has increased gradually and it is now widely employed in many branches of surgery, including urology, neurosurgery, cardiovascular surgery and orthopaedic surgery. 19 The present study investigated the effects of electrocautery plus hot compress compared with THM for controlling postoperative haemorrhage following decortication in adult patients with fibrothoracic disease secondary to symptomatic extraparenchymal restrictive disease.…”