Effectiveness of microporous polysaccharide hemospheres for achieving hemostasis in mohs micrographic surgery.
BACKGROUND
Microporous polysaccharide hemospheres consist of controlled-porosity spherical particles manufactured from bioinert plant polysaccharide. Microporous polysaccharide hemospheres facilitate hemostasis by rapidly absorbing the fluid component of blood, concentrating platelets and clotting factors to accelerate blood clotting.


OBJECTIVE
The objective was to compare a microporous polysaccharide hemosphere bandage and electrocautery in achieving hemostasis.


METHODS
Twenty-four patients with a total of 48 stages of Mohs micrographic surgery were included. Patients were stratified by whether or not they were taking anticoagulant medications. Within each group, patients were randomized to receive either the microporous polysaccharide hemosphere bandage or electrocautery. Outcomes included bleeding through the dressing (early time point) and active bleeding upon dressing removal (late time point).


RESULTS
Nineteen patients not taking anticoagulants had 40 stages, of which 18 received the study bandage and 22 received electrocautery. The remaining 5 patients on anticoagulants had 8 stages, of which 4 received the study bandage and 4 received electrocautery. In both total and subgroup analysis, there was a higher incidence of bleeding through the dressing with the study bandage (p<0.05), but no increase in the incidence of active bleeding upon dressing removal (p>0.05).


CONCLUSIONS
The microporous polysaccharide hemosphere study bandage had an increased incidence of bleeding through the dressing compared to electrocautery, but did not have an increased incidence of active bleeding upon dressing removal.
Tan
Stephen R
SR
Division of Dermatologic Surgery, Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA. srtan@iupui.edu
Tope
Whitney D
WD
D000368:Aged; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000379:methods; D009779:Occlusive Dressings; D011134:Polysaccharides / Q000008:administration & dosage*; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011446:Prospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D012878:Skin Neoplasms / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing
D011134:Polysaccharides; D012597:Sclerosing Solutions