Comparison of the efficacy of five standard topical hemostats: a study in porcine liver and spleen models of surgical bl
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RESEARCH ARTICLE
Open Access
Comparison of the efficacy of five standard topical hemostats: a study in porcine liver and spleen models of surgical bleeding Valerio Antonio Paternò1, Alessandro Bisin1*
and Alessandro Addis2
Abstract Background: Several topical hemostats are available to help control surgical bleeding. Cutanplast is a highly absorbent and porous gelatin product that is available in Fast sponge and powder forms. This study investigated the hemostatic efficacy of Cutanplast Standard and Fast gelatin sponge and powder and Emosist oxidized regenerated cellulose (ORC) gauze in porcine liver and spleen surgical bleeding models. Methods: Cutanplast Standard and Fast gelatin sponge and Emosist ORC gauze were tested in liver abrasion/ incision, liver puncture and spleen incision/puncture injuries, and Cutanplast Standard and Fast gelatin powder products were tested in liver abrasion/incision injuries. There were 13 liver injury (five abrasion, five incision and three puncture) and six spleen injury (three puncture and three incision sites) sites per animal. Results: Rapid hemostasis (≤ 2–5 min) was achieved in the liver abrasion and incision models with all Cutanplast gelatin sponge and powder products and Emosist ORC gauze, except in the liver incision model, time to hemostasis was > 5 min with Cutanplast Standard gelatin powder and Emosist ORC gauze. Rapid hemostasis occurred with Cutanplast Fast gelatin sponge and Emosist ORC gauze in the liver puncture and spleen puncture and incision models. In the spleen incision model, Cutanplast Standard gelatin sponge had a time to hemostasis approaching 10 min. Conclusion: Cutanplast gelatin sponge and powder products and Emosist ORC gauze may be suitable for surgical applications involving parenchymal organ bleeding, but certain products may perform better than others, including Cutanplast gelatin powder in diffuse mild bleeding (such as liver abrasion), and Cutanplast Fast gelatin sponge and Emosist ORC gauze for splenic bleeding. Keywords: Emosist, Cutanplast, Hemostat, Liver, Spleen, Surgical bleeding models
Background Bleeding is a frequent complication of surgery that can lead to substantial morbidity and mortality, longer surgeries and hospital stays, and increased total hospital costs [1–5]. Use of meticulous intraoperative hemostasis to reduce the risk of bleeding complications can be expected to have tremendous clinical and economic * Correspondence: [email protected] 1 Mascia Brunelli S.p.A, Viale Monza 272, 20128 Milan, Italy Full list of author information is available at the end of the article
benefits [1, 3]. In addition to conventional surgical methods (i.e., suturing and electrocautery), absorbable topical hemostatic agents can be used to improve surgical hemostasis [1, 6]. A variety of absorbable topical hemostats, including mechanical hemostats, are available to help control bleeding during a range of surgical procedures [7–11]. When directly applied to the bleeding surface, mechanical hemostats, which are appropriate for use in patie
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