Inherent Dangers of Simultaneous Application of Microfibrillar Collagen Hemostat and Blood-Saving Devices

Abstract

Microfibrillar collagen hemostat (MCH) is a topically applicable hemostatic agent which has been introduced in clinical practice recently and is marketed under different trade names and recommended for use in the course of surgical procedures. Because of the possibility that this substanee may pass through different blood-collecting circuits and cause organ damage if reintroduced into the patient’s circulation, a series of in vitro and in vivo experiments were performed. In the course of in vivo experiments the possible passage of MCH through "cell saver" devices was investigated. In Group A the passage of 1-125 labeled MCH was injected through different parts of a "cell saver" circuit. In Group B experiments the same was studied through a passage of 40μum pore-size blood transfusion filters. In the in vivo experiments MCH was injected intravenously into different parts of the' circulatory system of rabbits after different degrees of dilution and filtering after which the animals were killed at different time intervals and the radioactivity was determined in respective brain sections by microradiography. The results of these experiments suggest that the passage of MCH indeed occurs through different blood collecting and filtering devices and results in direct embolization of vital organs. This cannot be prevented even with the application of commercially used filters. Therefore, the authors recommend that the substance should not be used if shed blood is intended to be collected and returned to the patients circulation.

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

“…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.…”

In vitro Effect of a Microfibrillar Collagen Hemostat on Platelets

“…In an earlier paper we suggested the possibil ity of adverse consequences to the patient of the simultaneous use of the agent and de vices for salvaging and reinfusing red blood cells [6], because as much as 6% of the applied microfibrillar collagen was found to pass through 40-pm transfusion filters and so into the patient. Therefore, the recom- Fig.…”