[Experiences with the filling of traumatic brain defects with gelfoam plombage].
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Bronchial arteriography and embolization with sponge gelatin were performed in 100 tuberculous patients of massive hemoptysis. Three direct signs and other six indirect ones were found in arteriographies, Those signs were roentgenographic abnormalities for defining bleeding sites. 100 massive hemoptysis cases were treated with sponge gelatin embolization in bronchial artery. The results are satisfactory, the success rate were 92.9%, 87.4% and 79.0% at one week, one month and three months respectively. The advantages of arterial embolization and the reasons of failures were discussed in this paper.
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OBJECTIVES: We have investigated whether polylactic acid (PLA) sponge and fibroblast-growth-factor (FGF) released slowly from gelatin beads can induce fibrotic tissue in postpneumonectomy dead space. METHODS: Left pneumonectomy was performed in white Japanese rabbits. In the control group (N = 5), left chest was closed without any treatment. In the PLA sponge group (N = 5), PLA sponge and FGF (100 micrograms) released from gelatin beads were introduced into the left chest cavity. RESULTS: In the control group, herniation of the heart and right lung were observed without fibrotic material in the left chest cavity. In the PLA sponge group, dense fibrotic material was observed by chest CT scan 1 month after the operation. Pathological examinations revealed that PLA sponge and FGF did promote the organization of the fibrotic materials. CONCLUSIONS: Fibrotic materials can be induced in the postpneumonectomy dead space by PLA sponge and FGF released slowly from a gelatin sponge. New therapeutic method may be introduced near future by this concept, reduction of dead space with newly developed own fibrotic materials.
Stapled hemorrhoidectomy (PPH) is a modern approach to the treatment of hemorrhoids removing a circumferential strip of mucosa. In the same way the circumferential resection of the rectal prolapse (STARR) is successfully used for effective treatment of colporectocele and obstructed defecation syndrome. These surgical procedures offer several advantages over conventional techniques including reduced postoperative pain, stenosis and recurrences, an earlier recovery time and return to work. Furthermore, bleeding is one of the most common immediate complication (first week) and one of the possible late complication in these procedures. Our results with this surgery (153 PPH and 37 STARR) confirmed the data of many other Authors regarding the incidence of intra and early post-operative haemorrhages (1.3% in PPH and 2.7% in STARR). With the aim to reduce this complications, which represents the only negative side-effect of these procedures, we employed the FloSeal, a gelatine based haemostatic sealant with thrombin component, to control intraoperative bleeding. The preliminary results obtained in 10 PPH and in 7 STARR confirmed the theoretical usefulness of FloSeal in reducing this hemorrhagic complications.
The safety and efficacy of a new hemostatic sealant, based on a gel with collagen derived particles and topical thrombin (FloSeal, Fusion Medical Technologies, Inc. Fremont, CA) were assessed as an alternative to nasal packing for hemostasis in functional endoscopic sinus surgery. In a prospective clinical study of 50 patients undergoing bilateral endoscopic anterior ethmoidectomy, 2 ml FloSeal was used after surgery to stop bleeding. The results were compared to a control group of 50 patients with Merocel packing and showed that intraoperative hemostasis was rapid and equal in both groups. The main advantages of the new hemostatic sealant included a higher degree of comfort during postoperative nasal breathing and absence of complaints due to pressure or pain. There was only one case of postoperative bleeding on the 6th day, which required nasal packing. There were no more cases of stenoses or synechia in the ostiomeatal complex than were found in the Merocel group. No systemic side effects due to FloSeal were observed. This specific hemostatic sealant was shown to be a safe and efficacious alternative method for hemostasis in endoscopic sinus surgery with high patient satisfaction and an easy and fast mode of application.
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