Use of a chitosan-based hemostatic dressing in laparoscopic partial nephrectomy.
OBJECTIVE
An external chitosan-based hemostatic bandage has been used to control aggressive bleeding from traumatic injuries. This study was to evaluate the feasibility of using an internal chitosan dressing based on the external platform to control hemorrhage and urinary leakage by sealing off the parenchymal wound following Laparoscopic partial nephrectomy (LPN) in a porcine model.


METHODS
Nine heparinized domestic swine underwent bilateral laparoscopic partial nephrectomies involving either a polar (N = 13) or wedge resection (N = 5) followed by treatment with the chitosan dressing. Estimated blood loss, hemostatic score, urinary leakage, operative time, and adhesion score of the chitosan dressing were recorded.


RESULTS
Of the 18 procedures, 17 achieved complete hemostasis after deployment of the chitosan dressing. The hemostasis score improved significantly after the deployment in both polar (p < 0.001) and wedge (p = 0.017) resections. The rate of successful pyelocaliceal sealing was 85% (11/13) in polar resections and 60% (3/5) in wedge resections.


CONCLUSIONS
The chitosan-based hemostatic dressing is effective as a primary or supplemental material for controlling parenchymal hemorrhage and sealing the renal collecting system following LPN in the animal model.
Xie
Hua
H
Oregon Medical Laser Center, Providence St. Vincent Medical Center, Portland, Oregon, USA. hua.xie@providence.org
Khajanchee
Yashodhan S
YS
Teach
Jeffrey S
JS
Shaffer
Brian S
BS
D000818:Animals; D001458:Bandages; D001672:Biocompatible Materials / Q000737:chemistry / Q000627:therapeutic use; D048271:Chitosan / Q000737:chemistry / Q000627:therapeutic use; D006470:Hemorrhage / Q000628:therapy*; D006489:Hemostatic Techniques; D006490:Hemostatics / Q000737:chemistry / Q000627:therapeutic use; D006801:Humans; D010535:Laparoscopy; D008422:Materials Testing; D009392:Nephrectomy; D034421:Sus scrofa
D001672:Biocompatible Materials; D006490:Hemostatics; D048271:Chitosan