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Comparative safety and efficacy of topical hemostatic agents in a rat neurosurgical model.
- Source :
-
Neurosurgery [Neurosurgery] 2008 Oct; Vol. 63 (4 Suppl 2), pp. 369-72; discussion 372. - Publication Year :
- 2008
-
Abstract
- Objective: Adequate hemostasis is extremely important in neurosurgery, commonly requiring the use of topical hemostatic agents. Apart from variable efficacy, the residual presence of these agents may cause foreign body reaction, infection, and delayed bone growth. This study compares the safety and efficacy of commonly used agents with a newly approved agent, Arista (microporous polysaccharide hemospheres; Medafor, Inc., Minneapolis, MN).<br />Methods: A brain tissue defect was created in 228 Wistar outbred rats, and either no agent (negative control), Arista, Surgicel (oxidized cellulose; Ethicon, Inc., Somerville, NJ), Avitene (microfibrillar collagen; Alcon, Inc., Humacao, PR), FloSeal (gelatin matrix thrombin sealant; Baxter Healthcare Corp., Deerfield, IL), or kaolin (positive control) was implanted. Time to hemostasis was documented. The animals were sacrificed at different intervals up to 28 days, and presence of residual material and foreign body reaction was determined.<br />Results: Arista, Avitene, FloSeal, and Surgicel performed better (defined as complete hemostasis within 1 minute) than control (no treatment). Residual material was not present at any time with Arista, markedly contrasting with the presence of residual material in 100% of lesions in the Avitene, FloSeal, and Surgicel groups on Day 14. Avitene and FloSeal also demonstrated a propensity for causing granuloma formation, whereas Arista and Surgicel showed no such evidence.<br />Conclusion: Each of these hemostatic agents was effective in controlling bleeding in the majority of standardized neurosurgical lesions. Arista degrades more rapidly than Surgicel, Avitene, and FloSeal and does not result in any foreign body reaction.
- Subjects :
- Administration, Topical
Animals
Brain Injuries blood
Cellulose, Oxidized administration & dosage
Cellulose, Oxidized adverse effects
Collagen administration & dosage
Collagen adverse effects
Disease Models, Animal
Foreign-Body Reaction chemically induced
Gelatin Sponge, Absorbable administration & dosage
Gelatin Sponge, Absorbable adverse effects
Hemostatics adverse effects
Rats
Starch adverse effects
Survival Rate
Time Factors
Brain Injuries surgery
Hemostasis drug effects
Hemostatics administration & dosage
Neurosurgical Procedures adverse effects
Starch administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1524-4040
- Volume :
- 63
- Issue :
- 4 Suppl 2
- Database :
- MEDLINE
- Journal :
- Neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 18981845
- Full Text :
- https://doi.org/10.1227/01.NEU.0000327031.98098.DD