Analysis on the healing of gastrointestinal ulceration by using Hemospray

Christoph R Werner,Lena Brücklmeier,Nisar P Malek,Thomas Kratt,Bence Sipos,Martin Götz,Dörte Wichmann

doi:10.1038/s41598-021-98664-8

Christoph R Werner, Lena Brücklmeier + Show 5 more

Open Access

https://doi.org/10.1038/s41598-021-98664-8

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Abstract

Healing of gastrointestinal ulcers after Hemospray application was reported in literature. The pathophysiological mechanism of action of hemostatic powders is not elucidated so far. A prospective animal model was performed to evaluate the effect of Hemospray application on the healing process of artificially induced ulcers of the upper and lower gastrointestinal tract. In 10 pigs, 20 ulcers were created in each the upper and the lower gastrointestinal tract by endoscopic mucosal resection. 50% of the pigs were immediately treated with Hemospray application, the others were not treated. Ulcer size was measured endoscopically on day 0, 2, and 7. On day 7 the ulcers were histopathological evaluated for capillary ingrowth and the thickness of the collagen layer. After 7 days the sizes of the ulcers decreased significantly (stomach: − 22.8% with Hemospray application, − 19% without Hemospray application; rectum: − 50.8% with Hemospray application, − 49.5% without Hemospray application; p = 0.005–0.037), but without significant difference between both groups. This study shows no significant effect of the hemostatic powder Hemospray on ulcer healing in the upper and lower gastrointestinal tract compared with untreated controls, neither harmful nor beneficial. However, some trends merit further trials in patients and may indicate a possible mechanism of accelerated mucosal healing.

Highlights

Healing of gastrointestinal ulcers after Hemospray application was reported in literature
The incidence of Helicobacter pylori associated ulcers in the upper GI tract is declining, while other pathogenic causes as non-steroidal anti-inflammatory drugs and idiopathic ulcers are rising in incidence[1,2]
Comparing day 0 with day 7, as expected, the ulcers decreased in size due to mucosal healing

Summary

Introduction

Healing of gastrointestinal ulcers after Hemospray application was reported in literature. A prospective animal model was performed to evaluate the effect of Hemospray application on the healing process of artificially induced ulcers of the upper and lower gastrointestinal tract. In 10 pigs, 20 ulcers were created in each the upper and the lower gastrointestinal tract by endoscopic mucosal resection. This study shows no significant effect of the hemostatic powder Hemospray on ulcer healing in the upper and lower gastrointestinal tract compared with untreated controls, neither harmful nor beneficial. Literature research shows an animal study and a some case report of patients with healing ulcerations of the gastrointestinal tract following HSA10,11. The aim of this study was to evaluate a possible beneficial effect of HSA on ulcer healing in an in-vivo porcine model of upper and lower GI-ulceration and to generate hypotheses for further research

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