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PubMedDate not supplied

[Specific activity and toxicity of hemostatic feracryl-based plaster].

In experiments on 126 rabbits and 156 guinea pigs, a study was made of specific activity, subacute and chronic toxicity of a new hemostatic feracryl-based plaster. The data obtained indicate a pronounced and stable hemostatic activity of the plaster in different types of wounds demonstrated in two species of animals, including hypocoagulation state. The plaster exerts no local irritative, resorptive toxic effect on tissues and possesses no allergenic properties.

Acrylic Resins↗
PubMed1989

[Action and biocompatibility of two collagen-based hemostatics in animal experiments].

Efficacy and biocompatibility of two collagen hemostatic wound dressings (usual agent: Collastypt, fluid-stabilised agent: Lyostypt) were compared. In a prospective randomized study the local hemostatic effect (bleeding time and blood loss) of the two agents were investigated after liver trauma of 45 rats. Liver wounds which remained untreated served as controls. Both preparations significantly reduced bleeding. The fluid-stabilised agent was significantly superior to the second collagen agent of different manufacturing.

Animals↗
PubMed1978

Drug therapy reviews: clinical use of hemostatic agents.

Systemic hemostatic agents are reviewed. Among the agents discussed are vitamin K preparations (phytonadione, menadione, menadione sodium bisulfite, menadiol sodium diphosphate); and blood products (whole blood, plasma, cryoprecipitate, factor VIII concentrates, factor IX concentrates and fibrinogen concentrates). Normal and abnormal hemostasis and fibrinolysis are discussed, as is the general management of systemic hemostatic defects. Specific disorders covered are clotting factor deficiencies, hemophilia A, factor VIII inhibitors, von Willebrand disease, hemophilia B (Christmas disease), other congenital coagulation disorders, acquired deficiency of factors II, VII, IX and X, and defibrination syndrome.

Antibodies↗
PubMed1987

Experimental evaluation of amylose succinate absorbable hemostat in a canine model.

Using a semiquantitative animal model of standardized injuries to parenchymatous organs resulting in a range of degrees of hemorrhage, we compared freeze-dried amylose succinate topical hemostat to the most widely used commercially available products. Hemostatic efficacy parameters included bleeding time, blood loss, incidence of rebleeding, and amount of material used. Although no material was consistently superior in all parameters, in general amylose succinate and microcrystalline collagen performed equally well and both were significantly more effective than oxidized regenerated cellulose. Both amylose succinate and oxidized regenerated cellulose were superior to microcrystalline collagen, however, in biodegradation time, inflammatory response and adhesion-forming potential. Details of the animal model and an adhesion grading scheme are presented.

Absorption↗
PubMedDate not supplied

Topical hemostatic agents to reduce bleeding from cancellous bone surfaces: a comparison of Gelfoam paste and bone wax.

This article reviews the history of topical bone hemostatic agents, listing advantages and disadvantages of the more commonly used agents. Gelfoam paste and bone wax were chosen to study the effects that bone hemostatic agents have on the occurrence and severity of postoperative edema and pain. The authors discovered 80% of the patients utilizing bone wax, and 91% of the patients receiving Gelfoam paste, had markedly decreased amounts of immediate postoperative edema. Furthermore, 90% of the patients treated with bone wax, and 75% of the patients treated with Gelfoam paste, reported less postoperative pain than anticipated with the surgical procedure performed.

Administration, Topical↗
PubMed1986

Pigskin as a topical hemostat in arterial, liver, and splenic injuries.

Pigskin made commercially available as porcine-derived dermal collagen (PDC) contains a macrofibrillar collagen surface that initiates platelet aggregation and the intrinsic pathway clotting mechanism. Sterile-irradiated PDC, nonirradiated PDC, and lyophilized PDC were tested for hemostatic effectiveness and cost for hemostasis against each other and Avitene powder, Avitene web, Collastat, Gelfoam, Superstat, and Thrombostat. Canine arterial, liver, and splenic bleeding models were used. In arterial wounds PDC was more effective than Avitene powder, Avitene web, and Gelfoam (p less than 0.05) and also Superstat and Thrombostat (p less than 0.01). First application success rates revealed that PDC agents were more successful overall (85%) than the next three most successful agents: Avitene powder, Avitene web, and Collastat (56%) (p less than 0.01). Differences in success rates of hepatic and splenic wounds were less marked but still significant. Cost of hemostasis was relatively low for PDC agents in comparison to the other agents. PDC is an effective topical hemostatic agent in experimental canine arterial, liver, and splenic wounds when compared with several currently used agents and can also result in cost savings.

Administration, Topical↗
PubMed1986

Inherent dangers of simultaneous application of microfibrillar collagen hemostat and blood-saving devices.

Microfibrillar collagen hemostat is a topically applicable hemostatic agent that has been introduced relatively recently. Because of the possibility that this substance may pass through different blood-collecting circuits and cause organ damage if reintroduced into the patient's circulation, we performed a series of in vitro and in vivo experiments. The results of these experiments suggest that such a passage may indeed occur and could cause organ damage, either by direct or by induced embolization that cannot be completely prevented even with the application of commercially used filters. We therefore recommend that the substance should not be used if the shed blood is intended to be collected and returned into the patient's circulation.

Animals↗
PubMed1978

A new topical hemostatic agent in gynecologic surgery.

Experiences with a topical hemostatic agent, microfibrillar collagen (MFC), material made from beef hide dermis are recounted. Topical hemostasis is facilitated by virtue of its fibrillar structure forming a sticky matrix for platelet aggregation. The material was used in women undergoing cervical conization to determine its absorption at hysterectomy 6 weeks later. In another group, it was used as the sole hemostatic agent at conization and compared with a control group in which conventional sutures were used. A larger group who underwent abdominal hysterectomy allowed comparison between MFC on the bladder muscularis and conventional suture ligature in terms of blood loss, operating time success of method used, and complications.

Administration, Topical↗
PubMed1980

A new effective intraoperative hemostat - Superstat.

A new effective solvating hemostatic agent, Superstat, has been developed and evaluated in animals and man. It appears to work in part because of its large electron absorbing surface and in part due to the physiologic concentration of contained calcium. The available information from the first 130 patients in which it has been evaluated suggest that it has few, if any, side effects, leaves no residue following use, and is an extremely effective hemostat under most conditions and in all tested operative areas in man. Available data indicate that it has local effects which represent biochemical and ultra-structural interactions with shed blood.

Animals↗
PubMed1993

Local hemostatic technic using a celluloid splint in bleeding disorders.

Controlling hemorrhage from dental treatment in bleeding disorder patients is one of the most serious procedures encountered by the dentist. In the Dental Division, Ramathibodi hospital, dentists use local hemostatic technics combined with replacement therapy, local hemostatic agents and antifibrinolytics in the management of bleeding disorders in dental patients, such as leukemia, ITP, hemophilia. Celluloid splints as an adjunct therapy is very beneficial in controlling hemorrhage in dental procedures as shown by 5 years experience with 278 patients. The advantages are: less expensive, lesser days hospitalized, better outcomes. Presently it is used as a routine technic in dental treatment.

Blood Coagulation Disorders↗
PubMed1998

[Recurrent epistaxis in children as an indicator of hemostatic disorders].

OBJECTIVE: To distinguish which nosebleeds in children hide an underlying coagulation disorder, characteristics of recurrent epistaxis were evaluated correlating the severity with a battery of specific tests on primary and secondary hemostasis. PATIENTS AND METHODS: Epistaxis of fifty-eight children were classified as mild or severe according to frequency, duration, amount of blood lost, proportion of life that nosebleeds have been recurrent and uni- or bilateral bleeding. Epidemiological characteristics were evaluated, as well as hemostatic tests including: platelet count, mean platelet volume, plasmatic fibrinogen level, prothrombine time, activated partial thromboplastin time, thrombin time, bleeding time, von Willebrand factor antigen and ristocetin cofactor, factor VIII coagulant, and platelet aggregation to different agents. The effect of drugs or the presence of tumors was discarded. RESULTS: In the group of children with mild epistaxis (n = 39) there were three cases with laboratory abnormalities (10.3%). In severe epistaxis (n = 19) abnormalities were found in eleven cases (57.9%) and specific entities were detected in six of them (three children with von Willebrand's disease, one Bernard-Soulier syndrome, one autoimmune thrombocytopenic purpura and one Rendü-Osler-Weber disease). Epistaxis labeled as mild needed less cauterizations and packings, were more related to seasonal prevalence and self-handling, and poorly influenced iron metabolism. CONCLUSIONS: The five qualities pointed out on recurrent epistaxis in children allow the identification of who must be thoroughly studied by means of specific tests to rule out any kind of hemostatic disorder.

Adolescent↗
PubMed1984

Parotid gland surgery using the Shaw Hemostatic Scalpel.

Twenty-five patients who underwent parotid gland surgery using the Shaw Hemostatic Scalpel (group 1) were compared with 25 patients who had similar surgery using conventional techniques (group 2). Overall, the patients in group 1 had less blood loss and shorter operative times. In patients who underwent superficial parotidectomy, the incidence of temporary partial facial nerve paralysis was 31% in the experimental group v 43% in the conventional group. The mean number of branch paralyses per patient was one in group 1 v 1.9 in group 2, and time to recovery of full function was 50% less in group 1. The Shaw Hemostatic Scalpel is a safe, efficacious instrument for use in parotid gland surgery.

Evaluation Studies as Topic↗
PubMed1981

Microfibrillar collagen hemostatic pledgets.

The use of topical microfibrillar collagen hemostatic agents is increasing in many areas of clinical surgery. We have developed a method of preparing the hemostatic agent by which a pledget is formed in a syringe. This gives it a firm consistency and allows easier handling and application and can be done at the operating room table.

Collagen↗
PubMed1999

Effects of low molecular weight heparin, alone or combined with antithrombin III, on mortality, fibrin deposits and hemostatic parameters in endotoxin-induced disseminated intravascular coagulation in rabbits.

The effect of low molecular weight heparin (LMWH) with or without antithrombin III (AT III) has been studied in a rabbit model of disseminated intravascular coagulation (DIC) induced by continuous infusion of 100 microg/kg/hr of Escherichia coli endotoxin for 6 hr. LMWH (5 and 10 IU/kg/hr/6 hr), alone or in combination with AT III (20 U/kg/hr/6 hr), or saline were administered simultaneously with endotoxin. Hemostatic markers at 0, 2, and 6 hr as well as kidney fibrin deposits and the mortality rate at 24 hr were determined. Rabbits receiving only endotoxin showed an impairment in hemostasis, as well as high kidney fibrin deposits and a high mortality rate. LMWH alone did not exert any effect. The simultaneous infusion of LMWH and AT III exerted a beneficial effect on the hemostatic markers and reduced the kidney fibrin deposits as well as the mortality rate in a LMWH dose-dependent manner. Fibrinogen and protein C consumption were significantly higher and renal fibrin deposits more intense in the rabbits that had died in the first 24 hr. There was also a significant positive correlation between kidney fibrin deposits and platelets, fibrinogen, and protein C consumption, taking the whole rabbit population. It is concluded that the simultaneous infusion of LMWH and AT III is useful in this DIC model and would make it possible to reduce significantly the AT III doses used when AT III is given alone.

Animals↗
PubMed1997

Sheath pulling immediately after PTCA: comparison of two different deployment techniques for the hemostatic puncture closure device: a prospective, randomized study.

Sheath pulling immediately after percutaneous transluminal coronary angioplasty (PTCA) increases patients' comfort, decreases burden for the medical staff, and may reduce hospital costs by shortening the length of stay. Immediate sheath pulling in anticoagulated patients with a low risk of bleeding complications is feasible using hemostatic devices. For the hemostatic puncture closing device (HPCD), published data regarding sheath pulling in patients immediately after PTCA is limited. Furthermore, no study addressed the question whether the recommended deployment time (DT) of 30 min can be reduced to a few minutes. We, therefore, performed a prospective study, randomizing 140 patients to a DT of 5 and 30 min, respectively. There were no statistical differences in gender, age, height, weight, or cardiovascular risk factors between the two groups. Blood pressures measured invasively immediately before sheath removal were comparable. Activated coagulation time just prior to sheath removal was 227 +/- 52 sec in the DT-5 group and 223 +/- 37 sec in the DT-30 group. After deployment, 74% of the DT-5 patients and 71% of the DT-30 patients showed immediate and complete hemostasis. The remaining patients showed only little oozing with complete hemostasis at the time of the final device removal. Hematoma size after 24 hr was 6.2 +/- 4.4 cm2 for DT-5 and 6.8 +/- 8.2 cm2 for DT-30 patients. There was no statistical difference between both groups. No severe bleeding or major complications were observed in either group. Thus, the use of a collagen system with an intra-arterial anchor (HPCD) is effective and safe when sheaths are pulled immediately after PTCA. The reduction of deployment time from 30 to 5 min is not related to an increased risk of bleeding or other vascular complications; patients can be transferred much faster to the ward, therefore reducing the burden on the personnel in the catheterization laboratory and increasing patients' comfort by allowing them to return to their rooms without a sheath.

Adult↗
PubMed1977

Hemostatic factors in primary hepatocellular cancer.

Detailed coagulation studies were performed in a group of 19 patients with primary hepatocellular cancer (PHC) and the results were compared statistically with the findings in 19 control subjects. Various funcitonal and immunochemical methods were employed in determining the possible presence of functional or structural coagulant protein abnormalities. The patient group was characterized by prolonged prothrombin times, partial thromboplastin times, and Reptilase times, increased levels of fibrinogen, factor VIII, and factor VIII-related antigen, moderately devreased levels of factor V, factor IX, factor X, antithrombin III, and plasminogen, and reduced levels of factor II and factor VII. Functional, immunochemical, and biochemical analysis failed to detect the presence of acquired protein abnormalities. These findings indicate that hemostatic changes in primary hepatocellular cancer are nonspecific in character. Severe alterations in the plasma levels of one or more of these hemostatic factors may occur.

Adolescent↗
PubMed1988

Hemostatic effects of hormonal stimulation in patients with metastatic prostate cancer.

Hemostatic abnormalities are common in patients with metastatic malignancy and are attributed, in part, to materials secreted by tumor cells. Tumor stimulation might therefore cause further perturbation of hemostasis. This article reports observations on the effects of androgen stimulation on multiple hemostatic parameters in patients with metastatic prostate cancer. Testosterone was given before chemotherapy in an experimental protocol designed to increase tumor sensitivity to cytotoxic agents. The following parameters were measured on day 0 (before) and days 2 and 4 of fluoxymesterone administration: PT, APTT, platelet count, plasma betathromboglobulin (BTG), platelet factor 4 (PF4), fibrinogen, fibrin(ogen) split products (FSP), factor VIII coagulant activity (VIII C), von Willebrand factor antigen (vWF Ag), fibrinopeptide A (FPA), antithrombin III (AT III), and protein C antigen (PC). Ten patients were studied during 17 cycles of hormonal stimulation. Baseline levels of BTG, PF4, fibrinogen, FSP, factor VIII C, vWF Ag, and FPA were significantly elevated compared with normal control. Although androgen stimulation resulted in elevation of BTG, FPA, and FSP levels by day 4 in many patients, the changes for the entire group were not statistically significant. Other parameters remained unchanged or were only slightly elevated. Two patients developed laboratory evidence of disseminated intravascular coagulation (DIC) but were clinically unaffected. Our data suggest that most patients with metastatic prostate cancer show evidence of ongoing activation of platelets, coagulation, and fibrinolysis. In a few individual patients, androgen stimulation of this hormonally dependent tumor may cause further activation of platelets, coagulation, and fibrinolysis.

Aged↗
PubMed1989

Changes in hemostatic and fibrinolytic proteins in patients receiving L-asparaginase therapy.

Hemostatic changes were evaluated in ten patients with acute lymphoblastic leukemia and lymphoma who received chemotherapy with L-asparaginase, vincristine, and prednisolone for 1 week. Following treatment, prothrombin time and activated partial thromboplastin time were significantly prolonged, while a marked decrease in fibrinogen levels was observed. The values for cross-linked fibrin degradation products, however, remained within normal limits during treatment, which excluded the possibility of disseminated intravascular coagulation. The concentrations of coagulation inhibitors (antithrombin III, protein C, and protein S), plasminogen, and alpha 2 antiplasmin also significantly decreased; however, levels of both tissue-type plasminogen activator and plasminogen activator inhibitor, which are synthesized in endothelial cells, increased during the treatment. Although a decrease was observed in concentrations of many coagulation factors, including subunits A and B of factor XIII, the activity and antigenicity of factor VII significantly increased following the treatment. From this study, we concluded that these hemostatic abnormalities caused by the administration of L-asparaginase produced a labile condition that easily inclines to bleeding or thrombosis.

Anticoagulants↗