title: A novel gelatin sponge for accelerated hemostasis.
abstract: To more effectively manage the substantial bleeding encountered during surgical procedures in oto-rhino-laryngology, we developed a novel hemostatic sponge made of pharmaceutical grade, chemically cross-linked gelatin. The sponge is characterized by a high pore density, reduced ligaments, and a high nanoscale roughness of lamella surfaces in the matrix. In vitro blood uptake assays revealed a very rapid absorption of human blood, which was two to three times faster than that measured with comparative hemostyptic devices. In an in vitro hemorrhage model using human veins, the novel gelatin sponge matrix induced hemostasis less than a minute after bleeding was induced. The sponge was shown to bring about rapid hemostasis when it was administered in a young patient suffering from acute bleeding of a pharyngeal angiofibroma, even though the patient had been treated with an anticoagulant because of a transient ischemic attack. As the gelatin matrix of the sponge is biocompatible and resorbable, the hemostyptic device could be left in place and was shown to be resorbed within 2 weeks. We hypothesize that the excellent hemostatic performance of the sponge might be linked to enhanced capillary effects in conjunction with optimized anchoring of fibrinogen on the nano-rough material surface, as suggested by scanning electron microscopy. The novel gelatin sponge appears to be a promising hemostatic matrix, which could be of great benefit for patients suffering from epistaxis and other acute injuries resulting in severe bleeding.
authors.affiliation: NMI Natural and Medical Sciences Institute, University of Tübingen, Reutlingen D-72770, Germany.
authors.forename: Reiner
authors.initials: R
authors.lastname: Hajosch
authors.affiliation: Department of Oto-Rhino-Laryngology, University Medical Centre, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Suckfuell
authors.affiliation: Collagen Research Institute, University Campus at Kiel, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Oesser
authors.affiliation: GELITA AG, D-69412 Eberbach, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Ahlers
authors.affiliation: GELITA AG, D-69412 Eberbach, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Flechsenhar
authors.affiliation: NMI Natural and Medical Sciences Institute, University of Tübingen, Reutlingen D-72770, Germany.
authors.forename: Burkhard
authors.initials: B
authors.lastname: Schlosshauer
mesh_terms: D000042:Absorption; D018322:Angiofibroma / Q000098:blood supply / Q000473:pathology; D001769:Blood; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002648:Child; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D006470:Hemorrhage / Q000517:prevention & control; D006487:Hemostasis; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D008297:Male; D014680:Veins