Microporous polysaccharide hemosphere efficacy and safety in primary total knee arthroplasty

Gleason, Scott M.; Mehl, D.; Payne, William K.; Parry, Steve; Stein, Amy

doi:10.1016/j.jor.2018.11.006

Cited by 12 publications

(12 citation statements)

References 18 publications

(32 reference statements)

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“…MPH is theoretically expected to reduce hemorrhage and serous exudate ( 1 , 3 ), while its clinical effectiveness remains controversial. Several randomized, controlled studies in various types of surgery, including breast surgery, could not establish the effectiveness of MPH ( 4 - 6 ), while other retrospective studies showed the effectiveness of MPH in cardiothoracic surgery and total knee arthroplasty ( 7 , 8 ). One reason for such a discrepancy may be the small study populations that were analyzed.…”

Section: Discussionmentioning

confidence: 99%

“…Several randomized, controlled studies could not demonstrate the effectiveness of MPH in patients who underwent breast, thyroid and endoscopic sinus surgery ( 4 - 6 ). In contrast, the effectiveness of MPH in cardiothoracic surgery and total knee arthroplasty has been shown in several retrospective analyses ( 7 , 8 ). In this retrospective study, we evaluated the effectiveness of MPH in breast cancer surgery.…”

Section: Introductionmentioning

confidence: 99%

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Clinical effectiveness of microporous polysaccharide hemospheres in mastectomy for patients with breast cancer

Shinden,

Nomoto,

Nagata

et al. 2024

Gland Surg

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Background Microporous polysaccharide hemospheres (MPH) are hydrophilic particles administered to reduce the incidence of seroma after mastectomy, but their clinical effectiveness remains controversial. Because a previous randomized, controlled study in a small cohort could not demonstrate the effectiveness of MPH in breast surgery, we evaluated their effectiveness in surgery for breast cancer in a larger cohort. Methods Medical records of 352 patients who underwent total mastectomy for breast cancer were retrospectively reviewed. Clinical data were compared between 126 patients who received MPH during surgery (MPH group) and 226 who did not (control group) according to surgical procedures. Patients were significantly older in the MPH group than in the control group because of selection bias, but other factors, such as body mass index and number of dissected lymph nodes, did not differ between groups. Results When analyzed by use of axillary manipulation, the drain placement period and drainage volume were significantly less in the MPH group than in the control group for patients with mastectomy and sentinel lymph node biopsy. Only drainage volume was significantly less in the MPH group for patients with mastectomy and axillary lymph node dissection. The frequency of total postoperative complications, such as seroma requiring puncture, did not differ between groups. Conclusions Use of MPH may decrease the postoperative drainage volume and drain placement period in mastectomy for patients with breast cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical effectiveness of microporous polysaccharide hemospheres in mastectomy for patients with breast cancer

Shinden,

Nomoto,

Nagata

et al. 2024

Gland Surg

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“…MPHs use a sophisticated polymer crosslinking process based on plants to produce ultrahydrophilic, biocompatible particles. By absorbing the liquid portion of the blood and increasing the concentration of platelets and coagulation factors, they aid in the coagulation cascade [ 72 ]. Regardless of the patient’s coagulation status, the clotting process begins upon contact.…”

Section: Discussionmentioning

confidence: 99%

Maximizing Postoperative Recovery: The Role of Functional Biomaterials as Nasal Packs—A Comprehensive Systematic Review without Meta-Analysis (SWiM)

2023

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Numerous biomaterials have been developed over the years to enhance the outcomes of endoscopic sinus surgery (ESS) for patients with chronic rhinosinusitis. These products are specifically designed to prevent postoperative bleeding, optimize wound healing, and reduce inflammation. However, there is no singular material on the market that can be deemed the optimal material for the nasal pack. We systematically reviewed the available evidence to assess the functional biomaterial efficacy after ESS in prospective studies. The search was performed using predetermined inclusion and exclusion criteria, and 31 articles were identified in PubMed, Scopus, and Web of Science. The Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to assess each study’s risk of bias. The studies were critically analyzed and categorized into types of biomaterial and functional properties, according to synthesis without meta-analysis (SWiM) guidelines. Despite the heterogeneity between studies, it was observed that chitosan, gelatin, hyaluronic acid, and starch-derived materials exhibit better endoscopic scores and significant potential for use in nasal packing. The published data support the idea that applying a nasal pack after ESS improves wound healing and patient-reported outcomes.

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“…In fact, bandages with MPH applied to skin defects from Mohs surgery actually increased bleeding through the bandage and did not significantly affect bleeding after bandage removal 27 . MPH may similarly worsen bleeding after total knee arthroplasty 28 and in one animal study, it resulted in an increased risk of distal tip necrosis of local skin flaps 29 . In light of this, MPH should be used cautiously in areas undergoing locoregional reconstruction or within free flap recipients sites.…”

Section: Discussionmentioning

confidence: 99%

Effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complications

David

Zebolsky

Park

et al. 2022

Laryngoscope Investig Oto

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Background: Postoperative seroma is the most common donor site complication following anterolateral thigh (ALT) free flap harvest for head and neck reconstruction.The utility of novel microporous polysaccharide hemospheres (MPH) has not been studied as a hemostatic agent in this setting.Methods: Prospective, single-blind, randomized controlled trial of patients undergoing fasciocutaneous ALT harvest for head and neck reconstruction at a tertiary academic medical center between April 2018 and February 2020. The intervention (MPH) group received 3 g of topical MPH to the ALT donor site prior to closure whereas the control group did not receive application of MPH. Outcomes included total drain output (ml), drain output during postoperative days (POD) 1-3 alone, drain duration (days), and incidence of donor site hematoma, seroma, or infection.Results: Twenty-nine patients were randomized to the MPH group and 26 to the control group. For MPH and control groups, mean total drain output was 284.7 ± 153.0 ml versus 317.9 ± 177.6 ml (p = .527), mean POD 1-3 drain output alone was 169.3 ± 88.8 ml versus 157.9 ± 78.7 ml (p = .749), and drain duration was 5.9 ± 1.5 days versus 6.5 ± 1.6 days (p = .144), respectively. There was no significant difference in seroma (p = .733), hematoma (p = .492), or infection (p = 1.000). Drain output was not significantly influenced by gender, age, body weight, or smoking habits. Conclusion:MPH administration to ALT free flap donor sites did not significantly improve drain output, hematoma formation, or seroma formation.

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Microporous polysaccharide hemosphere efficacy and safety in primary total knee arthroplasty

Cited by 12 publications

References 18 publications

Clinical effectiveness of microporous polysaccharide hemospheres in mastectomy for patients with breast cancer

Clinical effectiveness of microporous polysaccharide hemospheres in mastectomy for patients with breast cancer

Maximizing Postoperative Recovery: The Role of Functional Biomaterials as Nasal Packs—A Comprehensive Systematic Review without Meta-Analysis (SWiM)

Effect of microporous polysaccharide hemospheres on anterolateral thigh free flap donor site complications

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