![]() Rapid hemostasis may be explained by platelet adhesion and activation of the natural coagulation system on the porous surface of the gelatin sponge. ĭeveloped in 1998, Cutanplast (Mascia Brunelli S.p.A., Milan, Italy) is a novel highly absorbent and porous gelatin product with a powerful hemostatic effect. Thanks to these features, ORC products are especially well known and widely used. 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. Gelatin sponge products differ with respect to gelatin density and porosity, which affects their biochemical and biological effects. Gelatin hemostatic devices are manufactured from animal-derived gelatin, and are available in sponge, powder, and granular forms that are highly absorptive and largely non-antigenic. Originally introduced over 60 years ago, gelatin- and oxidized regenerated cellulose (ORC)-based devices are two of the most commonly used mechanical hemostats. Mechanical hemostats are among the easiest to use, safest, and most low-cost hemostats available. When directly applied to the bleeding surface, mechanical hemostats, which are appropriate for use in patients with an intact coagulation system, provide a barrier to stop the flow of blood and a surface that passively promotes platelet activation and aggregation, and assists clot formation. ![]() Ī variety of absorbable topical hemostats, including mechanical hemostats, are available to help control bleeding during a range of surgical procedures. In addition to conventional surgical methods (i.e., suturing and electrocautery), absorbable topical hemostatic agents can be used to improve surgical hemostasis. Use of meticulous intraoperative hemostasis to reduce the risk of bleeding complications can be expected to have tremendous clinical and economic benefits. ConclusionĬutanplast 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.īleeding is a frequent complication of surgery that can lead to substantial morbidity and mortality, longer surgeries and hospital stays, and increased total hospital costs. In the spleen incision model, Cutanplast Standard gelatin sponge had a time to hemostasis approaching 10 min. Rapid hemostasis occurred with Cutanplast Fast gelatin sponge and Emosist ORC gauze in the liver puncture and spleen puncture and incision models. Rapid 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. 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. MethodsĬutanplast 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. 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. ![]() Cutanplast is a highly absorbent and porous gelatin product that is available in Fast sponge and powder forms. Several topical hemostats are available to help control surgical bleeding. ![]()
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