Abstract
BackgroundSeveral 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.MethodsCutanplast 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.ResultsRapid 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.ConclusionCutanplast 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.
Highlights
Several topical hemostats are available to help control surgical bleeding
Hemostatic devices All five hemostat devices used in this study (Cutanplast Standard and Fast gelatin sponge products, Cutanplast Standard and Fast gelatin powder products and Emosist oxidized regenerated cellulose (ORC) gauze) are manufactured by Mascia Brunelli S.p.A., Milan, Italy
With the exception of time to hemostasis with Cutanplast Standard sponge, grade 3.8 ratings were consistently obtained with Cutanplast Standard sponge and Fast powder in the liver incision model (Fig. 3)
Summary
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. ORC hemostatic products contain plant-derived continuous cellulose fibers in fabric formats that are easier to handle than gelatin sponge products, and as opposed to pH-neutral gelatin products, have a pH-lowering effect that contributes to hemostatic and bactericidal properties [7, 8, 10]. Thanks to these features, ORC products are especially well known and widely used [19,20,21]
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