Thermal Injury Resulting from Application of a Granular Mineral Hemostatic Agent

Wright, James K.; Kalns, John; Wolf, Edward A.; Traweek, Frederick; Schwarz, Stacy; Loeffler, Cleann K.; Snyder, William H.; Yantis, Loudon D.; Eggers, Jeffrey S.

doi:10.1097/01.ta.0000105916.30158.06

Cited by 123 publications

(85 citation statements)

References 9 publications

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“…Fibrin glue, microfiber hemostatic collagen, intercorporal suture techniques, argon beam coagulation, monopolar and bipolar electrocautery, laser and tissue welding, gelatin matrices, granular mineral hemostatic agents, hydrogels, and glutaraldehyde mixtures have all been used to achieve laparoscopic hemostasis. [7][8][9][10][11][12] Each has a unique risk and benefit profile as well as potential side effects. The ideal hemostatic agent would be nonimmunogenic, inexpensive, readily available, easy to deploy, and biodegradable, with no residual radiographic signature.…”

Section: Introductionmentioning

confidence: 99%

Renal Injury and the Application of Polysaccharide Hemospheres: A Laparoscopic Experimental Model

Humphreys

Lingeman

Terry

et al. 2008

Journal of Endourology

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Background and Purpose: Microporous polysaccharide hemospheres (MPH) are hemostatic beads engineered from purified plant starch. MPH accelerates the natural clotting cascade by concentrating clotting factors and proteins on their surface while absorbing aqueous and low molecular weight components from blood. The purpose of this study was to determine the efficacy of MPH in achieving hemostasis in the setting of laparoscopic renal injury. Materials and Methods:In four domestic pigs, 16 laparoscopic renal trocar injuries were created (8 each of 12 and 5 mm). A standard hand-assisted laparoscopic approach was used to each kidney so that two lesions per kidney were randomly created. MPH was applied to each treatment lesion with light pressure maintained for 60 seconds. Four of the 16 lesions, two each of 12 and 5 mm, were allowed to bleed as controls. Hemostasis was defined as no active bleeding or oozing. The animals were sacrificed at the conclusion of the procedure. Results: The mean time to hemostasis for the 12-mm MPH and control lesions was 196.2 Ϯ 53.3 and 372.0 Ϯ 225.6 seconds, while the average blood loss was 8.3 Ϯ 3.7 and 12.0 Ϯ 4.9 g, respectively. For the 5-mm MPH and control lesions, the average time to hemostasis was 100.2 Ϯ 24.8 and 247.0 Ϯ 134.4 seconds, while the average blood loss was 8.3 Ϯ 3.8 and 9.0 Ϯ 0.7 g, respectively. The median number of applications of the MPH for the 5-and 12-mm injuries was 1 and 2, respectively. Conclusions: MPH provided a rapid and effective means of hemostasis for laparoscopic renal parenchymal injuries in this model. Additional evaluation is warranted, however, before general application is advisable.

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Section: Introductionmentioning

confidence: 99%

Renal Injury and the Application of Polysaccharide Hemospheres: A Laparoscopic Experimental Model

Humphreys

Lingeman

Terry

et al. 2008

Journal of Endourology

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“…[3] Klasik yöntemlerle veya inorganik kökenli topikal hemostatik ajanlarla yapılan hemostazlar yanık, nekroz ve artmış enflamasyon gibi sorunlara yol açabilir. [4][5][6][7][8] Fibrin yapıştırıcı (FY) cerrahi pratikte geniş kullanım alanına sahip, organik kökenli topikal hemostatik ajandır. Depolama, hazırlık ve uygulama süreci kullanımını sınırlayabilir.…”

Section: Resultsunclassified

“…Ameliyat süresinin kısalması için, kanamanın kontrolünde topikal hemostatiklerin kullanımı da cerraha avantaj sağlayabilir Günümüz-de Japonya'da topikal hemostatiklerin karaciğer cerrahisinde standart bir endikasyon olmadan kullanımı %60'a kadar çıkmıştır. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Bu ajanların seçiminde cerrahın tercihi kadar, hemostatik materyalin yapısı, kanamanın ciddiyeti, acil ya da elektif cerrahi yaklaşımlar gibi faktörler oynar. Fiyat, uygulama kolaylığı ve muhafaza edilme özellikleri de seçimi etkilemektedir.…”

Section: Discussionunclassified

Comparison of the hemostatic efficiency of Ankaferd Blood Stopper and fibrin glue on a liver laceration model in rats

Akarsu¹,

Kalaycı²,

Yavuz³

et al. 2011

Ulus Travma Acil Cerrahi Derg

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“…Local cytotoxicity of old generation hemostatic agents treated with smectite or zeolite has been observed in many studies (Wright et al 2004, Gerlach et al 2010, Kheirabadi et al 2010, Li et al 2013). However, there are no previous reports on the distant toxic effect of the hemostatic dressing.…”

Section: Discussionmentioning

confidence: 99%

“…At the site of bleeding, zeolite effectively concentrates platelets and clotting factors, but it also releases Ca 2+ into the blood, which accelerates the intrinsic pathway of blood coagulation and shortens the clot formation time (Li et al 2013). However, upon contact with blood, zeolite causes an exothermic reaction, which damages the surrounding tissue (Wright et al 2004, Li et al 2013). Therefore, due to the high risk of tissue injury and microemboli formation, zeolite hemostatic dressings were removed from the United States military inventory (Gegel et al 2012).…”

Section: Introductionmentioning

confidence: 99%

Safety of the long-term application of QuikClot Combat Gauze, ChitoGauze PRO and Celox Gauze in a femoral artery injury model in swine – a preliminary study

Otrocka-Domagała

Jastrzębski

Adamiak

et al. 2016

Polish Journal of Veterinary Sciences

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The purpose of this study was to examine the safety of the long-term application of QuikClot Combat Gauze, ChitoGauze PRO and Celox Gauze using a swine model. The study was conducted on nine pigs weighing approximately 30 kg, which were randomly divided into three groups. Under deep anesthesia, the pigs underwent complete transverse cutting of the femoral artery in the groin region. Hemostatic dressings were left in the wound for 24 hours. The animals were euthanized 24 hours after dressing application. In each group, macroscopic and microscopic severe changes and shock symptoms were observed in the lungs, liver, kidneys and heart. Fibrino-gaseous embolic material was found in the pulmonary artery of each group and in the lung vessels of the animals from the ChitoGauze PRO and Celox Gauze groups. In conclusion, the long-term application of the evaluated hemostatic dressings has the risk of coagulopathy and reaching the progressive stage of shock. The residues from the hemostatic dressings can ingress into the systemic circulation, thereby increasing the risk of embolus formation. Because of these harmful effects, the evaluated hemostatic dressings are not appropriate for long-term use. Future studies are needed on the consequences of the long-term application of these hemostatic agents.

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Thermal Injury Resulting from Application of a Granular Mineral Hemostatic Agent

Abstract: Topical administration of a granular mineral hemostatic agent to a variety of wounds in an experimental swine model resulted in thermal tissue injury and necrosis. Suggestions for reducing the extent of injury with this product are offered.

Cited by 123 publications

References 9 publications

Renal Injury and the Application of Polysaccharide Hemospheres: A Laparoscopic Experimental Model

Renal Injury and the Application of Polysaccharide Hemospheres: A Laparoscopic Experimental Model

Comparison of the hemostatic efficiency of Ankaferd Blood Stopper and fibrin glue on a liver laceration model in rats

Safety of the long-term application of QuikClot Combat Gauze, ChitoGauze PRO and Celox Gauze in a femoral artery injury model in swine – a preliminary study

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