Two-layer sheet of gelatin: A new topical hemostatic agent
Two-layer sheet of gelatin: A new topical hemostatic agent
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DOI：
10.1016/j.asjsur.2016.09.007
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发表时间：
2018-03-01
影响因子：
3.5
通讯作者：
Hagiwara, Akeo
中科院分区：
文献类型：
--
作者：
Takagi, Toshitaka;Tsujimoto, Hiroyuki;Hagiwara, Akeo
背景/目的：不受控制的手术出血与发病率、死亡率和住院费用增加相关。目前可用的局部止血剂存在控制止血效果的问题;此外，它们的处理困难并且它们不安全。方法：我们设计了一种新的止血剂，其包括设计用于出血部位的明胶海绵和膜，从而产生仅由明胶制成的局部止血剂。通过碱处理来制备明胶以消除病毒活性。使用21只狗的脾评价材料，即双层明胶片、TachoSil和明胶海绵的止血效果、手术处理和组织反应。结果：与TachoSil（0-17%止血）相比，双层明胶片和明胶海绵表现出上级的止血效果（100%止血完成）。明胶基质立即吸收从伤口流出的血液，并激活吸收血液中的自体成分，促进出血部位的凝血。在评价的材料中，双层明胶片具有最佳的手术操作性。与TachoSil材料相比，明胶制成的材料与较少的炎症反应相关。结论：双层明胶片是一种有用的局部制剂，因为其上级止血效果和可用性，并且与较低的传播疾病和炎症反应的风险相关。(C)2016年亚洲外科协会和台湾机器人外科协会。出版社：Elsevier B. V.
Background/objective: Uncontrolled surgical bleeding is associated with increased morbidity, mortality, and hospital cost. Topical hemostatic agents available today have problems controlling hemostatic effects; furthermore, their handling is difficult and they are unsafe.Methods: We devised a new hemostatic agent comprising gelatin sponge and film designed to be applied to the bleeding site, thereby creating a topical hemostatic agent made of gelatin alone. The gelatin was prepared by alkali treatment to eliminate viral activity. Hemostatic effects, surgical handling, and tissue reactions of the materials, namely a two-layer sheet of gelatin, TachoSil, and gelatin sponge, were evaluated using 21 dogs' spleens.Results: The two-layer gelatin sheet and gelatin sponge exhibited superior hemostatic effects (100% hemostasis completed) compared with TachoSil (0-17% hemostasis). The gelatin matrix immediately absorbed blood flowing from wounds and activated the autologous components in the absorbed blood that promoted coagulation at the bleeding site. The two-layer gelatin sheet had the best surgical handling among the evaluated materials. Materials made of gelatin were associated with fewer inflammatory reactions compared with materials of TachoSil.Conclusion: The two-layer sheet of gelatin is a useful topical agent because of its superior hemostatic effects and usability, and is associated with a lower risk of transmitting diseases and inflammatory reactions. (C) 2016 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V.