Collagen hemostatic felt in coronary bypass surgery.

Abstract

The hemostatic effectiveness of collagen felt[1]) in coronary bypass surgery was evaluated in a population of 21 patients by using the conventional hemostasis in the first and every other operation and coIlagen felt in every second case, by placing 2 to 4 pieces of collagen felt (measuring 3 cm × 5 cm) in the upper mediastinum, in the jugulum, and also to cover the internal mammary artery bed whenever this artery was used for grafting. After closure of the chest, the total loss of blood was measured during 16 hours. In both groups the cases with the highest and the lowest blood loss were excluded from the study, thus leaving 8 patients in the collagen group and 9 patients in the control group. These groups were equal regarding age, sex distribution, and number of grafts. in both groups there was one case with concomitant aortic valve replacement. It was found that collagen felt was easy to use, it was firmly attached to the tissues, and it did not cause a drainage obstruction in any case. The recovery was uneventful with no cases of wound infection or sternal dehiscence. Postoperative bleeding was 30% higher in the control group than in the collagen group. There was no correlation between the number of bypass grafts and the amount of postoperative bleeding. In cases with concomitant valve replacement the amount of postoperative bleeding was reasonably low, 790 ml and 850 ml respectively. So, it is concluded that collagen hemostatic felt diminishes postoperative bleeding, is easy to use, is fixed firmly to the tissues, does not cause drainage obstruction, and does not affect wound healing. Therefore, collagen hemostatic felt can be recommended for use in connection with open-heart surgery.