Postoperative Small Bowel Obstruction Associated with Use of Hemostatic Agents

Hobday, Christopher; Milam, Michael R.; Milam, R. Ashley; Euscher, Elizabeth D.; Brown, Jubilee

doi:10.1016/j.jmig.2008.12.002

Cited by 33 publications

(28 citation statements)

References 7 publications

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“…Clinical observations indicate that surgical hemostatic agents can potentiate adhesion formation at the site of application 7–9. These observations were confirmed in the preclinical studies described in this report.…”

Section: Discussionsupporting

confidence: 83%

“…Other sinus studies, however, have demonstrated an increase in adhesion formation following FloSeal applications 16, 17. Recently, several clinical case reports detailed postoperative small bowel obstruction and pelvic pain secondary to adhesion formation associated with the use of FloSeal in patients undergoing pelvic surgery 7, 9, 11…”

Section: Discussionmentioning

confidence: 99%

“…Absorbable hemostatic agents are another valuable adjunct to surgical procedures, frequently used to limit both active bleeding and perioperative oozing. Although the impact of hemostatic agents on adhesion formation has not been well studied, case reports have detailed postoperative small bowel obstruction and pelvic pain secondary to adhesion formation associated with the use of hemostatic agents 7–11…”

Section: Introductionmentioning

confidence: 99%

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Adhesion formation to hemostatic agents and its reduction with a sodium hyaluronate/carboxymethylcellulose adhesion barrier

Greenawalt

Corazzini

Colt

et al. 2012

J Biomedical Materials Res

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The impact of hemostatic agents on postoperative adhesion formation has not been well studied. We hypothesized that hemostatic agents would be a significant nidus for adhesion formation and that a resorbable barrier would effectively reduce adhesions to hemostatic agents. Four commercial hemostatic agents, each composed of a different biomaterial matrix, were implanted in female Sprague-Dawley rats, and adhesion formation was examined 7 days after surgery. In separate studies, the effects of serosal trauma (via cecal abrasion), added blood, and the presence of chemically modified sodium hyaluronate/carboxymethylcellulose (HA/CMC) barrier on adhesion formation to hemostatic agents were studied. Significant adhesions formed to hemostatic agents even in the absence of traumatized tissue. When applied after cecal abrasion, the incidence of adhesions to the hemostatic agents increased. Addition of blood to this model increased adhesion formation even further, causing adhesions in every animal in the study. An HA/CMC adhesion barrier reduced adhesions to hemostatic agents in the presence of serosal trauma and maintained effectiveness even in the presence of blood. In conclusion, hemostatic agents potentiated adhesion formation at the site of application in a model without trauma. In more challenging models, their adhesiogenic contribution was overwhelmed by trauma and blood. HA/CMC adhesion barrier applied over hemostatic agents at the time of surgery provided significant protection against postoperative adhesions in these preclinical models.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Adhesion formation to hemostatic agents and its reduction with a sodium hyaluronate/carboxymethylcellulose adhesion barrier

Greenawalt

Corazzini

Colt

et al. 2012

J Biomedical Materials Res

View full text Add to dashboard Cite

show abstract

“…The gelatin-thrombin matrix has been used as an alternative treatment option in the cited studies of postpartum hemorrhage [3,4]. Despite the fact that other studies cited in the present study reported bowel obstruction associated with the use of gelatin-thrombin matrix, these studies were cited to set an example for the use of gelatin-thrombin matrix in gynecologic oncology operations and gynecologic operations [5,6].…”

mentioning

confidence: 70%

Response to: Microsurgical principles should be considered in studies addressing adhesion prevention: Çağlar et al. (2014)

Çağlar

2014

Arch Gynecol Obstet

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“…HAs may elicit a foreign body reaction leading to large giant cell granuloma, mimicking a metastatic disease [34,35]. HAs, frequently used during abdominal surgery, are linked to adhesion formation: a case of early post-operative small bowel obstruction during laparoscopic staging for endometrial cancer has been described, underling that the use of haemostatic agents should be considered as a cause in the differential diagnosis in patients with early post-operative bowel obstruction [36-38]. Not the least, application of FloSeal in the lumpectomy cavity has resulted in benign mammographyc microcalcifications that could be misinterpreted as malignant [39].…”

Section: Discussionmentioning

confidence: 99%

Haemostatics in surgery and our experience in the enucleoresection of renal cell carcinoma

et al. 2010

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Background30 patients, with T1 renal cell carcinomas (RCC) who underwent open enucleoresection of the tumour, were randomized to the use of a topical haemostatic agent (Floseal) or to an infrared-sapphire coagulator (ISC), to compare their efficacy in achieving haemostasis. Methods: Successful intra-operative haemostasis, intra- and post-operative bleeding, operative time, hospital discharge were evaluated.ResultsStatistically higher rates of successful haemostasis and shorter time-to-haemostasis (8,1 vs 12,9 min) were observed in the FloSeal group (p < 0.001 both). Patients operative time was not different between Group 1 vs 2 (58.7 ± 12 vs 62.4 ± 15; p > 0.05). The average blood loss during surgery was less (60 +/- 25.5 mL) for the FloSeal group than for the ISC group (85 +/- 40.5 mL) (p < 0.05). Postoperative blood loss was 25 +/- 5 mL and 40 +/- 45 mL for Floseal and ISC respectively, (p < 0.05). Length of the postoperative hospital discharge was 2.5 +/- 1.2 days for FloSeal group and 3.5 +/- 1.3 for the Group 2 (p < 0.05). No major immediate or delayed complications were observed in either Groups.ConclusionsThe use of Floseal and ISC offer a safe and efficacy haemostasis in the enucleoresection of RCC. Moreover, our results show a less intra-operative and post-operative blood loss as well as a shorter time to haemostasis of Floseal in respect to ISC.

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Postoperative Small Bowel Obstruction Associated with Use of Hemostatic Agents

Cited by 33 publications

References 7 publications

Adhesion formation to hemostatic agents and its reduction with a sodium hyaluronate/carboxymethylcellulose adhesion barrier

Adhesion formation to hemostatic agents and its reduction with a sodium hyaluronate/carboxymethylcellulose adhesion barrier

Response to: Microsurgical principles should be considered in studies addressing adhesion prevention: Çağlar et al. (2014)

Haemostatics in surgery and our experience in the enucleoresection of renal cell carcinoma

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