Remedy Publications LLC., | http://surgeryresearchjournal.com World Journal of Surgery and Surgical Research 2023 | Volume 6 | Article 15001 Physical Modification of a Gelatin Sponge Creates a Very Adhesive, Rapidly Absorbable, Blood-Free Hemostat

Abstract

Background: An effective hemostat not only needs to stop the bleeding whilst it is held in place but importantly, it must stay there securely during the perioperative recovery phases. As patients move during the recovery period, several forces can act on the hemostat leading to its displacement and possible postoperative hemorrhage. Adhesive hemostats have been developed to prevent this, but many contain human blood components or are prohibitively expensive for widespread use. This study evaluated a physical surface modification of a plain gelatin sponge with no additives (chemical/biologic), designed to securely adhere to bleeding tissue and create a long-lasting hemostatic matrix (TenaTac®, Selentus Science, UK). Methods: Adhesion and hemostasis were tested in a standard leporine hepatic bleeding model against the adhesive hemostats, TachoSil® and Hemopatch®. Absorption was tested in a porcine hepatic implantation model against plain gelatin sponge. Results: TenaTac was very well tolerated in the porcine model and was completely reabsorbed by day 14. TenaTac demonstrated a 69% improvement in adhesion over TachoSil (p<0.001). Hemostasis was also significantly better than TachoSil at the 6- & 9-min endpoints (p=0.016 & p=0.002). With systemic heparinization (300 u/kg) TenaTac’s adhesion score was 42.5% higher than non-heparinized TachoSil (p=0.003). After delivery through a laparoscopic cannula, the hemostasis and adhesive capabilities were not different from Hemopatch (p>0.05 for all). Conclusion: Physical surface modification of a gelatin sponge has resulted in a rapidly absorbable hemostat that demonstrates superior adhesion and hemostasis to other advanced hemostats.