Evaluation of a new hemostatic agent in experimental splenic laceration.
OBJECTIVE
To compare the effectiveness of several hemostatic agents and to evaluate a new hemostatic agent (ReClot) in controlling splenic hemorrhage.


METHODS
Rabbits were anesthetized and catheters placed. A celiotomy was performed and a splenic injury produced; hemostatic agent and compression were applied.
In group 1 (n = 8), the splenic laceration was compressed with a dry sponge and 75 g of pressure until hemorrhage ceased. In groups 2, 3, and 4 (n = 10 each), splenic injury was treated with Avitene, Collastat, and ReClot, respectively. Hemostatic agent was applied to the splenic laceration and a dry sponge and pressure were applied as described for group 1. In group 5 (n = 9), a splenic laceration was produced, ReClot applied, and aggressive fluid resuscitation was initiated; the volume of crystalloid was adjusted to maintain mean arterial pressure.


RESULTS
Application of a hemostatic agent reduced total blood loss compared with that measured in the control group, but there was no difference in blood loss among experimental groups treated with a hemostatic agent. The time required to achieve control of blood loss was less in the ReClot-treated group compared with the Avitene- and Collastat-treated groups.


CONCLUSIONS
The hemostatic agent ReClot had a significant advantage over other hemostatic agents for the time required to achieve control of splenic bleeding. Aggressive fluid resuscitation did not limit the ability of ReClot to produce hemostasis.
Horton
J W
JW
Department of Surgery, University of Texas Southwestern Medical Center, Dallas.
Garcia
N M
NM
Stone
K R
KR
D000138:Acidosis / Q000097:blood / Q000209:etiology; D000818:Animals; D001639:Bicarbonates / Q000097:blood; D001794:Blood Pressure / Q000502:physiology; D001810:Blood Volume / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D003094:Collagen / Q000627:therapeutic use; D004353:Drug Evaluation, Preclinical; D005440:Fluid Therapy; D006339:Heart Rate / Q000502:physiology; D006470:Hemorrhage / Q000097:blood / Q000517:prevention & control*; D006490:Hemostatics / Q000627:therapeutic use*; D007773:Lactates / Q000097:blood; D009930:Organic Chemicals; D011312:Pressure; D011817:Rabbits; D012119:Respiration / Q000502:physiology; D013154:Spleen / Q000293:injuries*; D013158:Splenic Diseases / Q000097:blood / Q000517:prevention & control*; D013318:Stroke Volume / Q000502:physiology; D015503:Surgical Sponges; D013997:Time Factors
D001639:Bicarbonates; D006490:Hemostatics; D007773:Lactates; D009930:Organic Chemicals; C091802:ReClot; D003094:Collagen