Inherent dangers of simultaneous application of microfibrillar collagen hemostat and blood-saving devices

Robicsek, Francis; Duncan, Gordon D.; Born, G. V. R.; Wilkinson, Hannah; Masters, Thomas N.; McClure, Myra O.

doi:10.1016/s0022-5223(19)35880-5

Cited by 34 publications

(8 citation statements)

References 12 publications

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“…Certain products added to the surgical site, such as topical hemostatic agents, may not be removed and may be toxic if reinfused. Microfibrillar collagen (Avitene™, Alcon Inc, Puerto Rico) and Surgicel™ (Johnson and Johnson, Arlington Texas) can potentially cause coagulopathy if reinfused 46 and Avitene is not removed by wash cycle. 46 Therefore, the safety of cell salvage after the use of these products is not established.…”

Section: Aspiration Of Products Added To Surgical Fieldmentioning

confidence: 99%

An Update on Perioperative Blood Salvage in Cardiac Surgery

Rubens

2005

Transfus Alt Transfus Med

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SUMMARY Blood conservation technologies are now the subject of increasing scrutiny in cardiovascular surgical care. In particular, positive outcomes in previous trials related to the collection and reinfusion of blood collected from the surgical wound (cell salvage) have now led this latter strategy to become a key component in modern surgical practice. Although intuitively attractive, there are, however, potential drawbacks relating to its usage including the risks of induced coagulopathy, infection and hemolysis. In this review, the principles and mechanics of cell salvage (processed, i.e. centrifugally washed, and unprocessed) as they relate to cardiac surgery, will be discussed. The impact of these techniques on the quality of harvested blood will be reviewed. Finally, the efficacy of this technology as a blood conservation strategy to limit the need for homologous transfusion as demonstrated in randomized clinical trials in cardiac surgery will be reviewed.

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Section: Aspiration Of Products Added To Surgical Fieldmentioning

confidence: 99%

An Update on Perioperative Blood Salvage in Cardiac Surgery

Rubens

2005

Transfus Alt Transfus Med

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“…Another contraindication is microfibrillar collagen materials which is not removed by washing. Infusion of units containing microfibrillar collagen has caused morbidity and mortality in animals (92).…”

Section: Contraindicationsmentioning

confidence: 99%

Autologous blood transfusion: Preoperative blood collection and blood salvage techniques

Bengtsson

Bengtson

1996

Acta Anaesthesiol Scand

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“…Avitene (Alcon Inc., Humacao, Puerto Rim) and other microfibrillar collagen hemostats (MCH) enhance local hemostasis by promoting platelet adherence and aggregation. A study of MCH in animals and in in vitro experiments was performed by Robicsek et al 76 They found that MCH separated along with the red cells during centrifugation and washing in cell salvage instruments and that, when infused, it can produce brain infarction and even death in experimental animals. Niebauer et a1. "…”

Section: Other Contraindicationsmentioning

confidence: 99%

“…Other collagen hemostatic compounds presumably pose the same risk. Robicsek et al 76 recommended discontinuing IBS once MCH is used. Of course, this may not always be feasible, but, at a minimum, users of intraoperative salvage must be aware of the risks, and every effort should be made to avoid contaminating the blood aspirated from the operative field with this material.…”

Section: Other Contraindicationsmentioning

confidence: 99%