title: Use of a plant-based polysaccharide hemostat for the treatment of sternal bleeding after median sternotomy.
abstract: BACKGROUND
  In cardiac surgery profuse or persistent sternal bleeding after sternotomy is routinely controlled with bone wax. However, bone wax should be avoided, especially in high-risk patients for nonunion of the sternum and infections. Purpose of this study was to evaluate an alternative technique to control bleeding after medium sternotomy using a plant based absorbable polysaccharide hemostat.
  
  
  METHODS
  A consecutive series of 38 patients requiring median sternotomy for coronary artery bypass surgery (21 OPCAB, 17 CABG) had sternal bleeding control with the polysaccharide hemostat, STARSIL® HEMOSTAT. This hemostat is a hydrophilic powder, which achieves hemostasis after topical application at the surgical wound site. Initially it dehydrates blood rapidly, thus accelerating aggregation of platelets and blood solids. Thereafter, it forms a gelled adhesive matrix, which serves as a mechanical barrier against further bleeding. The polysaccharide is completely resorbed within 48 to 72 hours.
  
  
  RESULTS
  Satisfactory control of sternal bleeding was observed in 37 patients (97%). No product-related complications were observed or any other major adverse events in an observation period of 3 months.
  
  
  CONCLUSIONS
  Polysaccharide hemostats appear to be safe and effective for bleeding control of the sternum.
authors.affiliation: Department of Cardiac Surgery, University of Munich, 81377, Munich, Germany. Christoph.Schmitz@med.uni-muenchen.de.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schmitz
authors.affiliation: Department of Cardiac Surgery, University of Munich, 81377, Munich, Germany. Ralf.Sodian@med.uni-muenchen.de.
authors.forename: Ralf
authors.initials: R
authors.lastname: Sodian
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy*; D006488:Hemostasis, Surgical / Q000379:methods*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064209:Phytochemicals / Q000627:therapeutic use*; D011134:Polysaccharides / Q000627:therapeutic use*; D056346:Sternotomy / Q000379:methods*; D013249:Sternum / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics; D064209:Phytochemicals; D011134:Polysaccharides