title: Evolution of fibrinogen-coated collagen patch for use as a topical hemostatic agent.
abstract: Human fibrinogen and thrombin have been combined and coated onto a collagen patch for use as a topical hemostatic agent. These agents have now been used for many years to induce rapid hemostasis and tissue sealing after various indications including thoracic-, plastic-, pediatric-, liver-, and minimally invasive surgery. The only ready-to-use fibrinogen-coated collagen patch at this moment, the third-generation surgical patch (SP-3), contains no bovine aprotinin (antifibrinolytic protein) in contrast to its precursor SP-2, and is thus devoid of bovine-derived components. In vitro studies have shown equal bioequivalence between SP-2 and SP-3. Various experiments in animal models under normal, stressful, and hyperfibrinolytic conditions showed that SP-3 has comparable tissue sealing properties and also outperformed fibrin sealants alone in some studies. The results from these pre-clinical bridging studies showed that aprotinin is not essential for the therapeutic efficacy of SP-3. In conclusion, SP-3 has evolved into a rapid, ready-to-use adjunct to primary measures for tissue sealing and hemostasis, suitable in cardiovascular-, thoracic-, neuro-, spleen-, kidney-, and liver-surgery.
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Deha
authors.initials: D
authors.lastname: Erdogan
authors.forename: Thomas M
authors.initials: TM
authors.lastname: van Gulik
mesh_terms: D000818:Animals; D007611:Aprotinin / Q000378:metabolism; D001458:Bandages; D003094:Collagen / Q000737:chemistry / Q000378:metabolism / Q000627:therapeutic use; D005340:Fibrinogen / Q000737:chemistry / Q000378:metabolism / Q000627:therapeutic use; D006470:Hemorrhage / Q000628:therapy; D006489:Hemostatic Techniques; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D014014:Tissue Adhesives / Q000737:chemistry / Q000627:therapeutic use