title: Efficacy of hemostatic matrix and microporous polysaccharide hemospheres.
abstract: BACKGROUND
  Microporous Polysaccharide Hemospheres (MPH) are a new plant-derived polysaccharide powder hemostat. Previous studies investigated MPH as a replacement to nonflowable hemostatic agents of different application techniques (e.g., oxidized cellulose, collagen); therefore, the purpose of this study was to determine if MPH is a surrogate for flowable hemostatic agents of similar handling and application techniques, specifically a flowable thrombin-gelatin hemostatic matrix.
  
  
  METHODS
  Hemostatic efficacy was compared using a heparinized porcine abrasion model mimicking a capsular tear of a parenchymal organ. MPH (ARISTA, 1 g) and hemostatic matrix (Floseal, 1 mL) were applied, according to a randomized scheme, to paired hepatic abrasions (40 lesions per group). Hemostatic success, control of bleeding, and blood loss were assessed 2, 5, and 10 min after treatment. Hemostatic success and control of bleeding were analyzed using odds ratios and blood loss using mean differences.
  
  
  RESULTS
  Hemostatic matrix provided superior hemostatic success relative to MPH at 5 (odds ratio: 0.035, 95% confidence interval: 0.004-0.278) and 10 min (0.032, 0.007-0.150), provided superior control of bleeding at 5 (0.006, <0.001-0.037) and 10 min (0.009, 0.001-0.051), and had significantly less blood loss at 5 (mean difference: 0.3118 mL/min, 95% confidence interval: 0.0939-0.5296) and 10 min (0.5025, 0.2489-0.7561).
  
  
  CONCLUSIONS
  These findings corroborate other MPH investigations regarding its low-level efficacy and suggest that MPH is not an appropriate surrogate for hemostatic matrix despite similar application techniques. The lack of a procoagulant within MPH may likely be the reason for its lower efficacy and need for multiple applications.
authors.affiliation: Baxter Healthcare Corporation, Deerfield, Illinois. Electronic address: kevin_lewis@baxter.com.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Lewis
authors.affiliation: H Atlee Consulting, Baltimore, Maryland.
authors.forename: Holly
authors.initials: H
authors.lastname: Atlee
authors.affiliation: Baxter Healthcare Corporation, Deerfield, Illinois.
authors.forename: Angela
authors.initials: A
authors.lastname: Mannone
authors.affiliation: JBS Consulting Services, Carlsbad, California.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Lin
authors.affiliation: Baxter Innovations GmbH, Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Goppelt
mesh_terms: D000007:Abdominal Injuries / Q000628:therapy*; D000818:Animals; D002417:Cattle; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D006488:Hemostasis, Surgical; D006801:Humans; D008099:Liver / Q000293:injuries*; D011897:Random Allocation; D013213:Starch / Q000627:therapeutic use*; D013552:Swine
chemical_list: C527600:Arista; C411004:FloSeal Matrix; D013213:Starch
keywords: ARISTA AH; Floseal; Hemostasis; Hemostats; Microporous polysaccharide hemospheres