Abstract
TetraStat is a tetra-armed polyethylene glycol (PEG) hydrogel. It is a synthetic sealant that solidifies instantly in response to pH changes. This study aimed to evaluate the hemostatic effect of TetraStat through experiments evaluating future clinical applications. We used TetraStat, oxidized regenerated cellulose (SURGICEL®), and fibrinogen and thrombin sealant patch (TachoSil®) using invitro and invivo experiments. For the invitro experiment, a closed circulatory system filled with phosphate-buffered saline under high pressure was used. Needle punctures were created and closed using the various sealants. For the invivo experiment, rat venae cavae were punctured with 18- and 20-gauge (G) needles, and hemorrhage was allowed to occur for several seconds. A porous PEG sponge soaked with TetraStat was applied as a hemostatic system. Hemostasis outcomes were compared among the various concentrations (40-100g/L) of TetraStat, SURGICEL, and TachoSil. The punctured holes in the prosthetic graft were successfully sealed with TetraStat in 1min. The success rate of hemostasis with TetraStat for the punctured holes in the rat vena cava was dose-dependent. TetraStat was effective in sealing the holes created with a 20G needle at all concentrations; however, the holes created with an 18G needle could be sealed only when the concentration ≥60g/L. Hemostasis using SURGICEL or TachoSil was less successful and sometimes required up to 5min. TetraStat has a high hemostatic ability. A porous PEG sponge soaked with TetraStat is a useful choice for effective hemostasis during massive hemorrhage.
Highlights
Hemorrhage control is crucial for the success of surgical procedures
TetraStat was effective at all applied concentrations in sealing punctures made using the 20-G needle
Successful hemostasis was observed in some cases in which SURGICEL and TachoSil were used
Summary
Even after attempting to control hemorrhage through suturing the bleeding sites, surgeons sometimes encounter situations where achieving hemostasis is difficult. These include disseminated intravascular coagulation owing to cancer, pregnancy, infection, massive tissue injury, and uncontrolled oozing from needle holes under heparinization in cardiovascular surgeries. For the in vivo experiment, rat venae cavae were punctured with 18- and 20-gauge (G) needles, and hemorrhage was allowed to occur for several seconds. A porous PEG sponge soaked with TetraStat was applied as a hemostatic system. The success rate of hemostasis with TetraStat for the punctured holes in the rat vena cava was dose-dependent. A porous PEG sponge soaked with TetraStat is a useful choice for effective hemostasis during massive hemorrhage
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