Two-layer sheet of gelatin: A new topical hemostatic agent.
OBJECTIVE
Uncontrolled surgical bleeding is associated with increased morbidity, mortality, and hospital cost. Topical hemostatic agents available today have problems controlling hemostatic effects; furthermore, their handling is difficult and they are unsafe.


METHODS
We devised a new hemostatic agent comprising gelatin sponge and film designed to be applied to the bleeding site, thereby creating a topical hemostatic agent made of gelatin alone. The gelatin was prepared by alkali treatment to eliminate viral activity. Hemostatic effects, surgical handling, and tissue reactions of the materials, namely a two-layer sheet of gelatin, TachoSil, and gelatin sponge, were evaluated using 21 dogs' spleens.


RESULTS
The two-layer gelatin sheet and gelatin sponge exhibited superior hemostatic effects (100% hemostasis completed) compared with TachoSil (0-17% hemostasis). The gelatin matrix immediately absorbed blood flowing from wounds and activated the autologous components in the absorbed blood that promoted coagulation at the bleeding site. The two-layer gelatin sheet had the best surgical handling among the evaluated materials. Materials made of gelatin were associated with fewer inflammatory reactions compared with materials of TachoSil.


CONCLUSIONS
The two-layer sheet of gelatin is a useful topical agent because of its superior hemostatic effects and usability, and is associated with a lower risk of transmitting diseases and inflammatory reactions.
Department of Medical Life System, Doshisha University, Kyoto, Japan; Department of Internal Medicine, Hushimi Okamoto Hospital, Kyoto, Japan.
Toshitaka
T
Takagi
Department of Medical Life System, Doshisha University, Kyoto, Japan.
Hiroyuki
H
Tsujimoto
Department of Medical Life System, Doshisha University, Kyoto, Japan; Department of Surgery, Kusatsu General Hospital, Shiga, Japan.
Hiroko
H
Torii
Department of Medical Life System, Doshisha University, Kyoto, Japan; Department of Surgery, Kusatsu General Hospital, Shiga, Japan.
Yuki
Y
Ozamoto
Department of Medical Life System, Doshisha University, Kyoto, Japan. Electronic address: marina.1108@zeus.eonet.ne.jp.
Akeo
A
Hagiwara
D000287:Administration, Topical; D000818:Animals; D016009:Chi-Square Distribution; D004195:Disease Models, Animal; D004285:Dogs; D004338:Drug Combinations; D005260:Female; D005340:Fibrinogen / Q000627:therapeutic use*; D005780:Gelatin; D006490:Hemostatics / Q000627:therapeutic use*; D008422:Materials Testing; D019106:Postoperative Hemorrhage / Q000628:therapy*; D011897:Random Allocation; D013156:Splenectomy / Q000009:adverse effects* / Q000379:methods; D013552:Swine; D013917:Thrombin / Q000627:therapeutic use*
D004338:Drug Combinations; D006490:Hemostatics; C518955:TachoSil; D005780:Gelatin; D005340:Fibrinogen; D013917:Thrombin
TachoSil; animal experiment; gelatin; topical hemostatic agent; two-layer sheet