OBJECTIVETo explore the efficacy of homemade hemostatics of injected gelatin matrix (HIGM) for immediately treating blunt hepatic trauma in canine model without additional pressure.

METHODSA total of 27 commercial hybrid dogs underwent celiotomy to establish hepatic trauma model after general anesthesia. The dogs were prospectively randomized into 3 groups: the treatment group (n=9, with the direct application of homemade hemostat), the positive control group (n=9, with thrombin solution), and the negative control group (n=9, with 0.9% normal saline). Time to hemostasis and intra-abdominal blood loss were recorded, and heart rate (HR), mean arterial pressure (MAP), and hematological parameters were compared among these three groups. Gross examinations were performed 30 minutes after surgery.

RESULTSSignificantly shorter time to hemostasis [(1.20±0.33) min] and less blood loss [(47.22±8.61) ml] were observed in the treatment group than in control groups (P 0.05). No cases of bleeding occurred in any animals in the treatment group, and no signs of infection and adhesion formation were evident due to exposure to HIGM. Two cases in the positive control group (22.22%) were found to have rebleeding. All animals in the negative control group experienced visible bleeding.

CONCLUSIONHIGM is effective for controlling bleeding after hepatic trauma without the additional compression, and therefore may be valuable in field surgery.

Animals ; Disease Models, Animal ; Dogs ; Gelatin ; administration & dosage ; Hemostatics ; administration & dosage ; Injections ; Liver ; injuries

The treatment of bleeding wound of solid visceral and the rescue of uncontrollable bleeding are still confronted with difficulties in surgery and first-aid field. Many researchers devote to study in the field of hemostasis, and the novel porous hemostatic agent is one of the hot spot of research about hemostasis. The review focuses on the hemostatic effect, properties, hemostatic mechanism, shortcoming and future trends of three novel porous hemostatic agents such as polysaccharides, zeolite and wollastonite.
Calcium Compounds ; Hemorrhage ; therapy ; Hemostatic Techniques ; Hemostatics ; administration & dosage ; chemistry ; Humans ; Polysaccharides ; Porosity ; Silicates ; Zeolites

A porous composite particle (CP) was fabricated by the methods of emulsification and cross-link based on chitosan, alginate and collagen protein, and the tranexamic acid-loaded composite particles (TACP) was prepared by immersing the composite particle into the solution of tranexamic acid and by freeze drying. In the hepatic and splenic hemorrhage model of rabbits, CP and TACP were randomly used as haemostatic agents, and the Suxiaozhixuefen (Flashclot) was used as control. The corresponding hemostatic time and bleeding amount were observed respectively. The hemostatic time of CP and Flashclot were (2.48 +/- 0.88) min and (3.07 +/- 0.84) min, respectively, no significant difference was observed. However, the hemostatic time of TACP was (1.90 +/- 0.75) min, which was significantly shorter than that of CP and Flashclot (P < 0.05). In the splenic bleeding model of rabbits, similar results were obtained with these three kinds of hemostatics. These results indicated that the CP based on chitosan, alginate and collagen protein displayed similar hemostatic efficiency to Flashclot. However, the TACP might be one of promising haemostatic powders due to its more excellent hemostatic efficiency.
Alginates ; administration & dosage ; pharmacology ; Animals ; Biocompatible Materials ; chemistry ; Chitosan ; administration & dosage ; pharmacology ; Collagen ; administration & dosage ; pharmacology ; Female ; Hemostatics ; administration & dosage ; pharmacology ; Male ; Rabbits ; Tranexamic Acid ; administration & dosage ; pharmacology

OBJECTIVETo explore the effectiveness of absorbable hemostatic fluid gelatin in preventing postoperative cerebrospinal fluid leakage.

METHODSThe clinical data of 17 patients with dura mater tear were retrospectively analyzed from March to September in 2003. There were 16 males and 1 female, aged from 16 to 67 years old with an average of (39.6 ± 15.4) years. The injury site was at cervical vertebrae in 1 case, thoracic vertebrae in 9 cases, thoracolumbar junction in 4 cases, lumbar vertebrae in 3 cases. There were burst fracture in 4 cases and fracture-dislocation in 13 cases. According to ASIA grade, 12 cases were grade A, 2 cases were grade B, 2 cases were grade D, 1 case were grade E. Two cases caused by traffic accident, 10 by high falling, 4 by heavy parts crash, 1 by stairs fell during the earthquake. Absorbable hemostatic fluid gelatins were used to plug the dura mater tear,in order to prevent postoperative cerebrospinal fluid leakage. Postoperative drainage were recorded every day.

RESULTSOf 17 patients, 15 cases did not develop with cerebrospinal fluid leakage. Two cases develop with cerebrospinal fluid leakage after operation and their drainage were removed at 6 to 7 days after operation. In all cases, no complications related with cerebrospinal fluid leakage occurred, such as headache, dizzy, fever,neck resistance, rash, incision disunion, incision infection, hematoma, neurologic symptoms aggravation. No abnormal phenomena was found on incision surrounding at follow-up of 9 months.

CONCLUSIONUsing absorbable hemostatic fluid gelatin to plug the dura mater tear during operation is an effective method in preventing postoperative cerebrospinal fluid leakage.

Adolescent ; Adult ; Aged ; Cerebrospinal Fluid Leak ; prevention & control ; Female ; Gelatin ; administration & dosage ; Hemostatics ; administration & dosage ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control

OBJECTIVETo search new effective compounds, the different hemostatic effects of Flos Sophorae, Flos Sophorae Carbonisatus and principal constituent were observed.

METHODUsing the bleeding time (BT) and the recalcification time (RT) as the specificity indicators for the hematischesis function, the hemostatic effects of the following were observed. Flos Sophorae, Flos Sophorae Carbonisatus, characteristic value extraction thing A and B (SCE A and B) and the principal constituent after orally administered in normal rats in order to analyze the new hemostatic compounds.

RESULTFlos Sophorae, and Flos Sophorae Carbonisatus can obviously reduce BT and RT in rats, in which the effect of Carbonisatus is stronger than the crude. Otherwhile, SCE A and SCE B can also obviously reduce BT and RT in rats, in which the effects of SCE B surpassed those of SCE A. Furthermore, two characteristic compounds extracted from SCE B (kaikasaponin I called compound 1 and isorhamnetin-3-O-rutinoside named called 2) and other nominated principal constituents (rutin, tannin), can obviously shorten BT and RT in rats, among which compound 2 is most superior.

CONCLUSIONThe Flos Sophorae, Flos Sophorae Carbonisatus and their character compounds can shorten! the BT and RT in rats. The compound 2 from SCE B has the most superior effect. Study showed that compound 2 should be the new hemostatic compounds after Flos Sophorae carbonized. The results also indicated that the increase of hemostatic effect after Flos Sophorae carbonized should be related with the coordination of various kinds of ingredient.

Animals ; Bleeding Time ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Flowers ; chemistry ; Hemostatics ; administration & dosage ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sophora ; chemistry

This paper reviews the mechanisms and properties of different absorbable hemostatic agents. The development tendency of absorbable hemostatic agent is forecasted. Its' qualities of being useful to surgeons are introduced and are embodied in surgeon's comprehending of the hemostatic characteristic of absorbable hemostatic agents as well as in their clinical use of such agents accurately. At the same time, the researchers in pursuit of the medical materials can work with reference to the data herein presented.
Absorption ; Animals ; Blood Loss, Surgical ; prevention & control ; Cellulose, Oxidized ; administration & dosage ; pharmacology ; Chitosan ; administration & dosage ; pharmacology ; Fibrin Tissue Adhesive ; administration & dosage ; pharmacology ; Gelatin Sponge, Absorbable ; administration & dosage ; pharmacology ; Hemostatics ; administration & dosage ; pharmacology ; Humans

BACKGROUNDThe non-operation treatment of intra-abdominal trauma guided contrast enhanced ultrasound (CEUS) is one of the hottest research topic. Gelatin/thrombin/calcium (GTC) was developed as a novel haemostatic agent for non-operable intra-abdominal trauma. We hypothesized that GTC can achieve haemostasis (without the use of pressure) within a short time in a large wound model by percutaneous injection under CEUS guidance.

METHODSForty Wister rats received large liver injuries by haemostatic clamp and were randomly divided into four groups, according to the haemostatic agent used. These included normal saline (NS) group A, lyophilising thrombin powder (LTP) group B, GTC group C, and absorbable α-cyanoacrylate (ACNA) group D. Each injury site was treated with one of the above materials and total bleeding time was recorded. All liver wounds were evaluated using CEUS at three periods: pre-injury, injury and post-treatment. The liver wounds were also evaluated by histology 3, 6, and 9 days after injury and the extents of abdominal adhesions were recorded.

RESULTSThe sensitivity of CEUS (100%) in detecting blunt traumatic liver lesions was significantly higher than conventional ultrasound (42.5%). Bleeding times at the injury site in the GTC group C ((129.3 ± 14.0) seconds) and ACNA group D ((5.2 ± 1.0) seconds) were significantly shorter than those in the NS group A ((369.5 ± 48.8) seconds, P < 0.01) and LTP group B ((324.7 ± 52.22) seconds, P < 0.01). The LTP group B showed no significant difference compared with the NS group A. Gross examination of liver tissue revealed that there were fewer intra-abdominal adhesions in the GTC group C (10%) than in the ACNA group D (100%). Histopathologic examination showed that GTC was completely absorbed after nine days.

CONCLUSIONSGTC, delivered by percutaneous injection under CEUS, may achieve haemostasis (without the use of pressure) within a short time in a large wound model. GTC is absorbable and may prevent intra-abdominal adhesions. Therefore, it may be the optimal choice for first aid treatment of large abdominal wounds in the setting of blunt trauma.

Animals ; Calcium ; administration & dosage ; therapeutic use ; Gelatin ; administration & dosage ; therapeutic use ; Hemorrhage ; diagnostic imaging ; drug therapy ; Hemostatics ; administration & dosage ; therapeutic use ; Injections ; Liver ; diagnostic imaging ; injuries ; Male ; Random Allocation ; Rats ; Rats, Wistar ; Thrombin ; administration & dosage ; therapeutic use ; Ultrasonography

The aerosol of biodegradable multi-function film were prepared, whose properties, affective factors and hemostasis effect were studied. Film formation properties were investigated in different lots of aerosols, including film formation time, uniformity, film particle size and film thickness. Young's modulus was about 0. 0373GPa, and elongation at break was 0. 89% by means of tensile method. It is proved that the aerosol of biodegradable multi-function film is easy to form films and its hemostasis effect is well.
Aerosols ; chemical synthesis ; Animals ; Biocompatible Materials ; therapeutic use ; Biodegradation, Environmental ; Hemostasis, Surgical ; methods ; Hemostatics ; administration & dosage ; Male ; Membranes, Artificial ; Particle Size ; Random Allocation ; Rats ; Rats, Wistar

This study was aimed to develop a new generation of ideal hemostatic powder which can be safely, effectively and easily used mainly to first aid anterior to hospital by the synergistic effect of physical and chemical hemostatic mechanisms. The tranexamic acid(TA)-loaded porous starch(PS) (TAPS) was prepared by using PS as carrier and TA as loaded drug component. The absorption property of TAPS was evaluated by water absorption; the hemostatic ability of TAPS was evaluated by test in vitro and in vivo, the blood coagulation time of TAPS was detected by using Lee-white method. The experiment was divided into 3 groups: blank control group, Yunnan Baiyao group and TAPS group, each group with 10 blood samples in vitro test; the 27 SD rats were used to test in vivo, and randomly were divided into 3 groups: PS,Yunnan Baiyao and TAPS, each group consisted of 9 rats for establishing the animal model of liver trauma and detecting the complete hemostasis time. The results showed that the water absorption of PS did not be affected by TA when dose of TA loaded in PS was <0.02 g/g PS. There was no statistic difference in blood coagulation time between TAPS and PS groups(P > 0.05). The complete hemostatic time of TAPS for trauma of left lobe liver was 236.67 ± 55.00 seconds, which was shorter than that of Yunnan Baiyao (340.00 ± 73.48 seconds) and PS (396.67 ± 68.37 seconds) (P < 0.05 and P < 0.01, respectively). It is concluded that PS can load TA and play the hemostatic effect through releasing TA; the TA loading <0.02 g/g PS did not affect the water absorption and pro-coagulation properties. The TA can enhance the hemostatic efficacy of PS, the hemostatic property of TAPS is derived from synergism of physical and chemical hemostatic mechanisms.
Animals ; Blood Coagulation Tests ; Drug Carriers ; Hemostatics ; chemical synthesis ; pharmacology ; Male ; Rats ; Rats, Sprague-Dawley ; Starch ; administration & dosage ; Tranexamic Acid ; chemical synthesis ; pharmacology

OBJECTIVE: To observe the self-developed horn type of titanium clamp used for inferior turbinate resection from filling effect. METHOD: Choose the cases of inferior turbinate resection of 152 cases randomly selected 92 cases (group) in 2-4 angle type titanium clip head-tail closed wound middle turbinate, and therefore more than nasal passages in the surgical wound, just as in the nasal passages above micro tamponade, bare breathing zone, keep the ventilation, 1- 3 days to take out the angle titanium clamp; 60 cases (control group) with vaseline oil gauze or postoperative Merocel hemostatic sponge tamponade nasal bleeding. Observation of 1-3 days after nasal ventilation, headache, nasal bleeding, dry mouth, tolerance is painful, aural fullness tinnitus, a total of 7 indicators of sleep. RESULT: The team outside the there was no difference in blood loss and the control group, the rest of the indicators is better than the control group. CONCLUSION The angle of titanium clamp used in inferior turbinate resection from stuffing, patients get better comfort, avoid drawn yarn of pain, improve the quality of perioperative patients with life.
Bandages ; Blood Loss, Surgical ; prevention & control ; Epistaxis ; prevention & control ; Female ; Formaldehyde ; administration & dosage ; Hemostatics ; administration & dosage ; Humans ; Male ; Microsurgery ; Nasal Cavity ; Polyvinyl Alcohol ; administration & dosage ; Postoperative Hemorrhage ; prevention & control ; Surgical Instruments ; Titanium ; Turbinates ; surgery