New haemostat in thoracic surgery

Abstract

INTRODUCTION: The authors present the results of a promising method to reduce peroperative bleeding in thoracic surgery within large thoracic surgical interventions. Usage of a resorbable haemostat on the basis of oxidized cellulose in the form of cotton wool may minimize the cause of bleeding, mainly in patients with postinfl ammatory thoracic complications. The strong point of this material is its easy application and malleability. Another advantage is the long-term antibacterial effect caused by lowering pH during its biodegradation. AIM: Retrospective evaluation of post-operative blood losses, time of thoracic drainage, length of hospitalisation, and development of infl ammatory indicators between groups using and not using haemostats. METHODOLOGY: A group consisted of 48 patients (group A), who underwent operation for post-infl ammatory thoracic complications and where haemostat was used. Using the pair selection method, 48 patients were selected to the control group B, where no haemostats were applied during operation. The selection depended on a similar demographic profi le, identical diagnosis, and a type of operations. Post-operational blood loss, dynamics of haematological profi le, time of thoracic drainage, blood parameters value, infl ammatory response of the organism, and length of hospitalisation. RESULTS: A key differentiation of dynamics in development was found between the groups in the concentration of haemoglobin and haematocrit in the post-operative period, in the time of thoracic drainage, and in total length of hospitalisation. A sudden rise of CRP serum values in the group A after 12 hours after application of haemostat was recorded, most probably as manifestation of the aseptic pleuritic (Tab. 4, Fig. 1, Ref. 16).

Comparison of Efficacy and Safety of Non-Regenerated and Regenerated Oxidized Cellulose Based Fibrous Haemostats

“…The vast majority of published works were performed with haemostats based on ORC (2)(3)(4)(5)(6)(7)(8)(9). Only few papers describe the effect of ONRC haemostatic gauze (10)(11)(12)(13)(14) or felt (15)(16)(17) and only one published work compares the effect of ORC and ONRC knitted gauze in a larger group of patients (18). The works published so far show that ONRC has a similar or even superior effect (10,18).…”