Comparison of absorbable materials for surgical haemostasis.
The haemostatic effect of two new materials has been compared with surgical gauze and oxidized cellulose using a standardized liver laceration in New Zealand White rabbits. Following excision of a 3 cm2 disc of tissue from the liver, 42 rabbits were randomized to the use of gauze swabs (n = 6), oxidized cellulose (Surgicel) (n = 12), porcine collagen (Medistat) (n = 12) or calcium alginate (Kaltostat) (n = 12) to control the resulting haemorrhage. Blood loss and time to haemostasis were accurately recorded. The absorbable materials were left in situ and animals killed between 2 weeks and 6 months later to examine speed of absorption and resulting adhesions. Calcium alginate stopped bleeding in less than 3 min in all animals compared with a mean (+/- s.e.m.) of 5.7 +/- 0.75 min for porcine collagen, 12.5 +/- 0.9 min for oxidized cellulose and greater than 15 min with gauze (P less than 0.001). Oxidized cellulose and calcium alginate reabsorbed within 3 months leaving a fibrous scar, but a vigorous foreign body reaction was seen with porcine collagen which caused intestinal obstruction in 5 out of 12 animals within 3 months.
Blair
S D
SD
Department of Surgery, Charing Cross and Westminster Medical School, London, UK.
Backhouse
C M
CM
Harper
R
R
Matthews
J
J
McCollum
C N
CN
D000042:Absorption; D000464:Alginates; D000818:Animals; D002483:Cellulose, Oxidized; D003094:Collagen; D020723:Glucuronic Acid; D006470:Hemorrhage / Q000473:pathology / Q000503:physiopathology*; D006488:Hemostasis, Surgical; D006603:Hexuronic Acids; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000473:pathology / Q000503:physiopathology*; D011817:Rabbits; D011897:Random Allocation; D013523:Surgical Equipment; D013997:Time Factors
D000464:Alginates; D002483:Cellulose, Oxidized; D006603:Hexuronic Acids; D020723:Glucuronic Acid; D003094:Collagen