Topical hemostatic agents in neurosurgery, a comprehensive review: 15 years update

Schonauer, Claudio; Mastantuoni, Ciro; Somma, Teresa; Falco, Raffaele de; Cappabianca, Paolo; Tessitore, Enrico

doi:10.1007/s10143-021-01684-1

Cited by 6 publications

(4 citation statements)

References 93 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Post-operative bleeding and orbital or intracranial hemorrhage can be prevented by a thorough hemostasis and a proper deployment of hemostatic agents ( Schonauer et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Transorbital and supraorbital uniportal multicorridor approach to the orbit, anterior, middle and posterior cranial fossa: Anatomic study

Zoia,

Mastantuoni,

Solari

et al. 2024

Brain and Spine

View full text Add to dashboard Cite

“…Post-operative bleeding and orbital or intracranial hemorrhage can be prevented by a thorough hemostasis and a proper deployment of hemostatic agents ( Schonauer et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Transorbital and supraorbital uniportal multicorridor approach to the orbit, anterior, middle and posterior cranial fossa: Anatomic study

Zoia,

Mastantuoni,

Solari

et al. 2024

Brain and Spine

View full text Add to dashboard Cite

“…Currently, various hemostatic materials and medical devices have been assayed to achieve superior operative outcome, avoid post-operative bleeding, and control inadvertent neurovascular injury. [165,168] Although MIS treatments severely lack standard protocol and the recommendatory procedures varied worldwide, major vessel hemorrhage is still a potentially catastrophic complication in neurosurgery, [169] since the high-pressure/high-flow scenarios, together with frequent loss of vision and limited operative access, can put patients' lives at imminent risk. In neural surgery, the carotid artery injury is one of the most challenging scenarios for neurosurgical surgeon.…”

Section: Hemostatic Use In Neurosurgerymentioning

confidence: 99%

“…In clinics, neurosurgical hemostasis is mainly achieved with bipolar coagulation, which not only requires optimal and safe intraoperative control of hemorrhage and but also requests rapid coagulation of small vessel. [ 164 ] Alongside the evolution of modern neurosurgery, the safe, rapid, and robust hemostasis requires developing valid biomaterial alternatives with unique hemostatic, sealing, and adhesive properties, [ 165 ] such as specific adhesives to bleeding surface, highly pliable placement in operative space, clear visualization of covered tissue structure after application, that is fast acting, fast absorbing, and has high transparency to view. To achieve effective ultra‐early hemostatic therapy in ICH, a humanized monoclonal antibody fragment of idarucizumab against dabigatran (direct thrombin inhibitor) was approved by FDA for hemostatic use in surgical emergency situation.…”

Section: Clinical or Preclinical Use Of Dsap Biomaterials In Surgical...mentioning

confidence: 99%

Short Peptide Nanofiber Biomaterials Ameliorate Local Hemostatic Capacity of Surgical Materials and Intraoperative Hemostatic Applications in Clinics

et al. 2023

View full text Add to dashboard Cite

Short designer self‐assembling peptide (dSAP) biomaterials are a new addition to the hemostat group. It may provide a diverse and robust toolbox for surgeons to integrate wound microenvironment with much safer and stronger hemostatic capacity than conventional materials and hemostatic agents. Especially in noncompressible torso hemorrhage (NCTH), diffuse mucosal surface bleeding, and internal medical bleeding (IMB), with respect to the optimal hemostatic formulation, dSAP biomaterials are the ingenious nanofiber alternatives to make bioactive neural scaffold, nasal packing, large mucosal surface coverage in gastrointestinal surgery (esophagus, gastric lesion, duodenum, and lower digestive tract), epicardiac cell‐delivery carrier, transparent matrix barrier, and so on. Herein, in multiple surgical specialties, dSAP‐biomaterial‐based nano‐hemostats achieve safe, effective, and immediate hemostasis, facile wound healing, and potentially reduce the risks in delayed bleeding, rebleeding, post‐operative bleeding, or related complications. The biosafety in vivo, bleeding indications, tissue‐sealing quality, surgical feasibility, and local usability are addressed comprehensively and sequentially and pursued to develop useful surgical techniques with better hemostatic performance. Here, the state of the art and all‐round advancements of nano‐hemostatic approaches in surgery are provided. Relevant critical insights will inspire exciting investigations on peptide nanotechnology, next‐generation biomaterials, and better promising prospects in clinics.

show abstract

“…There are many different hemostatic products currently available for clinical use, which are often classified into four general categories: mechanical, biologically active, flowable agents, and sealants. 2,[9][10][11] Mechanical hemostats (eg, bone wax, gelatin sponges, oxidized regenerated cellulose), which are generally more affordable and easier to apply than other products, use physical means to limit bleeding and/or help activate the extrinsic coagulation cascade by serving as a scaffold for clot formation. These products are most successful in treating minimal bleeds in patients with intact coagulation systems and adequate space for access.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Flowable Collagen Hemostat Evaluated in Preclinical Models of Liver Injury and Spinal Cord Exposure

Lake¹,

Bradbury²,

Gagne³

et al. 2023

MDER

View full text Add to dashboard Cite

Introduction Excessive bleeding in trauma and surgical settings leads to increased operative time, reoperation rates, and overall healthcare costs. A wide range of hemostatic agents have been developed to control bleeding that can vary considerably in type of hemostatic action, ease of application, cost, risk of infection, and dependence on patient coagulation. Microfibrillar collagen-based hemostatic materials (MCH) have yielded beneficial results in a variety of applications. Methods A new flowable collagen product, containing a modified MCH flour, but in a more convenient flowable delivery system, was evaluated for hemostatic efficacy in preclinical models of solid organ injury and spinal cord exposure. The primary objective of this study was to compare the hemostatic potential and local tissue responses to this novel, flowable collagen-based hemostatic agent to the original flour formulation to confirm that the new method of delivery did not interfere with the hemostatic properties of the MCH flour. Results When observed visually, the flowable MCH flour mixed with saline (FL) provided more precise application and uniform coverage to injured tissues compared to the dry MCH flour alone (F 0 ). All of the treatments (FL, F 0 , and gauze) exhibited comparable Lewis bleed grade at all three time points evaluated in the capsular resection liver injury model (bleed grade: 1.0–1.3; p > 0.05 in all cases). FL and F 0 exhibited comparable 100% acute hemostatic efficacy and similar long-term histomorphological properties (up to 120 days) in a capsular resection liver injury in pigs, while gauze resulted in significantly lower rates of acute hemostatic efficacy (8–42%, p <0.05 in all cases). In an ovine model of dorsal laminectomy and durotomy, FL and F 0 again exhibited comparable results without any neurological effects. Conclusion Flowable microfibrillar collagen was shown to yield favorable short- and long-term outcomes in two representative applications where hemostatic efficacy is critical to surgical success.

show abstract

Topical hemostatic agents in neurosurgery, a comprehensive review: 15 years update

Cited by 6 publications

References 93 publications

Transorbital and supraorbital uniportal multicorridor approach to the orbit, anterior, middle and posterior cranial fossa: Anatomic study

Transorbital and supraorbital uniportal multicorridor approach to the orbit, anterior, middle and posterior cranial fossa: Anatomic study

Short Peptide Nanofiber Biomaterials Ameliorate Local Hemostatic Capacity of Surgical Materials and Intraoperative Hemostatic Applications in Clinics

Efficacy of Flowable Collagen Hemostat Evaluated in Preclinical Models of Liver Injury and Spinal Cord Exposure

Contact Info

Product

Resources

About