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LyBarger KS. Review of Evidence Supporting the Arista™ Absorbable Powder Hemostat. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2024; 17:173-188. [PMID: 38800552 PMCID: PMC11127658 DOI: 10.2147/mder.s442944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/21/2024] [Indexed: 05/29/2024] Open
Abstract
Background Uncontrolled and diffuse bleeding is a dreaded event during open and laparoscopic surgery that may lead to postoperative complications, obstruction of the surgical field that reduces visualization, and prolonged operating times. Powder hemostats can be used to control bleeding and are easy to use, have a safe profile, and can achieve broad coverage area at a low cost. Methods A strategic literature search of peer-reviewed, English language studies was conducted to capture evidence on the clinical efficacy and safety of a Microporous Polysaccharide Hemosphere (MPH) based Hemostat (Arista™ Absorbable Hemostat (Arista™ AH)). Results Six preclinical studies were found which supported the use of MPH in various animal models of laparoscopic and open surgery, all of which demonstrated its safety and efficacy. Five single-arm and 11 comparative clinical studies similarly supported the efficacy and safety of MPH in various surgery types, including cardiac, renal, and dermatologic surgery. Conclusion Published evidence supports the safe and effective use of MPH across a variety of surgical settings.
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Chen YW, Lu CH, Shen MH, Lin SY, Chen CH, Chuang CK, Ho CC. In vitro evaluation of the hyaluronic acid/alginate composite powder for topical haemostasis and wound healing. Int Wound J 2019; 17:394-404. [PMID: 31845534 DOI: 10.1111/iwj.13285] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 12/02/2019] [Accepted: 12/05/2019] [Indexed: 01/14/2023] Open
Abstract
The use of haemostatic agents can provide life-saving treatment for patients who suffer from massive bleeding in both prehospital and intraoperative conditions. However, there are still urgent demands for novel haemostatic materials that exhibit better haemostatic activity, biocompatibility, and biodegradability than existing products. In the present study, we aim to evaluate the feasibility of new wound dressing, RapidClot, for treating uncontrolled haemorrhage through a series of in vitro assessments to determine the swelling ratio, clotting time, enzymatic degradation, haemolytic activity, cytotoxicity, cell proliferation, and migration. The results indicated that the RapidClot revealed better water adsorption capacity and shorter blood clotting time (132.7 seconds) than two commercially available haemostatic agents Celox (378.7 seconds) and WoundSeal (705.3 seconds). Additionally, the RapidClot dressing exhibited a similar level of degradability in the presence of hyaluronidase and lysozyme as that of Celox, whereas negligible degradation of WoundSeal was obtained. Although both Celox and RapidClot revealed a similar level in cell viability (above than 90%) against NIH/3 T3 fibroblasts, improved cell proliferation and migration could be obtained in RapidClot. Taking together, our results demonstrated that RapidClot could possess a great potential for serving as an efficient healing dressing with haemorrhage control ability.
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Affiliation(s)
- Yi-Wen Chen
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung City, Taiwan.,3D Printing Medical Research Center, China Medical University Hospital, Taichung City, Taiwan
| | - Chia-Hsin Lu
- Research and Development Division, Jing-Te Biomedical Technology Co., Ltd., Taichung City, Taiwan
| | - Meng-Han Shen
- Research and Development Division, Jing-Te Biomedical Technology Co., Ltd., Taichung City, Taiwan
| | - Shih-Yeh Lin
- Research and Development Division, Jing-Te Biomedical Technology Co., Ltd., Taichung City, Taiwan
| | - Chia-Hui Chen
- Research and Development Division, Jing-Te Biomedical Technology Co., Ltd., Taichung City, Taiwan
| | - Ching-Kuang Chuang
- Research and Development Division, Jing-Te Biomedical Technology Co., Ltd., Taichung City, Taiwan
| | - Chia-Che Ho
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung City, Taiwan
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Chiara O, Cimbanassi S, Bellanova G, Chiarugi M, Mingoli A, Olivero G, Ribaldi S, Tugnoli G, Basilicò S, Bindi F, Briani L, Renzi F, Chirletti P, Di Grezia G, Martino A, Marzaioli R, Noschese G, Portolani N, Ruscelli P, Zago M, Sgardello S, Stagnitti F, Miniello S. A systematic review on the use of topical hemostats in trauma and emergency surgery. BMC Surg 2018; 18:68. [PMID: 30157821 PMCID: PMC6116382 DOI: 10.1186/s12893-018-0398-z] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 08/20/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND A wide variety of hemostats are available as adjunctive measures to improve hemostasis during surgical procedures if residual bleeding persists despite correct application of conventional methods for hemorrhage control. Some are considered active agents, since they contain fibrinogen and thrombin and actively participate at the end of the coagulation cascade to form a fibrin clot, whereas others to be effective require an intact coagulation system. The aim of this study is to provide an evidence-based approach to correctly select the available agents to help physicians to use the most appropriate hemostat according to the clinical setting, surgical problem and patient's coagulation status. METHODS The literature from 2000 to 2016 was systematically screened according to PRISMA [Preferred Reporting Items for Systematic Reviews and Meta-Analyses] protocol. Sixty-six articles were reviewed by a panel of experts to assign grade of recommendation (GoR) and level of evidence (LoE) using the GRADE [Grading of Recommendations Assessment, Development and Evaluation] system, and a national meeting was held. RESULTS Fibrin adhesives, in liquid form (fibrin glues) or with stiff collagen fleece (fibrin patch) are effective in the presence of spontaneous or drug-induced coagulation disorders. Mechanical hemostats should be preferred in patients who have an intact coagulation system. Sealants are effective, irrespective of patient's coagulation status, to improve control of residual oozing. Hemostatic dressings represent a valuable option in case of external hemorrhage at junctional sites or when tourniquets are impractical or ineffective. CONCLUSIONS Local hemostatic agents are dissimilar products with different indications. A knowledge of the properties of each single agent should be in the armamentarium of acute care surgeons in order to select the appropriate product in different clinical conditions.
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Affiliation(s)
- Osvaldo Chiara
- General Surgery-Trauma Team, State University of Milano, Niguarda Hospital Milano, Piazza Benefattori dell’Ospedale, 3, 20162 Milan, Italy
| | | | | | - Massimo Chiarugi
- Emergency Surgery Unit, State University of Pisa, Cisanello Hospital, Pisa, Italy
| | - Andrea Mingoli
- Trauma Surgery Unit-Department of Surgery-Emergency Surgery Department Policlinico Umberto I-Rome, Rome, Italy
| | - Giorgio Olivero
- Department of Surgical Sciences, State University of Torino, Turin, Italy
| | | | | | - Silvia Basilicò
- General Surgery-Trauma Team, State University of Milano, Niguarda Hospital Milano, Piazza Benefattori dell’Ospedale, 3, 20162 Milan, Italy
| | - Francesca Bindi
- General Surgery-Trauma Team, State University of Milano, Niguarda Hospital Milano, Piazza Benefattori dell’Ospedale, 3, 20162 Milan, Italy
| | - Laura Briani
- General Surgery-Trauma Team, State University of Milano, Niguarda Hospital Milano, Piazza Benefattori dell’Ospedale, 3, 20162 Milan, Italy
| | - Federica Renzi
- General Surgery-Trauma Team, State University of Milano, Niguarda Hospital Milano, Piazza Benefattori dell’Ospedale, 3, 20162 Milan, Italy
| | - Piero Chirletti
- General Surgery and Pancreatic Surgery Unit, State University La Sapienza, Rome, Italy
| | | | - Antonio Martino
- Honorable Chief- Emergency Surgery, Cardarelli Hospital, Naples, Italy
| | - Rinaldo Marzaioli
- Department of Emergency and Transplant Surgery, State University of Bari, Bari, Italy
| | | | - Nazario Portolani
- Department of Clinical and Experimental Sciences-State University of Brescia, Bari, Italy
| | - Paolo Ruscelli
- Department of Emergency Surgery, Ospedali Riuniti, Ancona, Italy
| | - Mauro Zago
- Minimally Invasive Surgery Unit- Policlinico S. Pietro, Ponte San Pietro, Bergamo, Italy
| | - Sebastian Sgardello
- General Surgery-Trauma Team, State University of Milano, Niguarda Hospital Milano, Piazza Benefattori dell’Ospedale, 3, 20162 Milan, Italy
| | - Franco Stagnitti
- State University of Rome “La Sapienza”-Polo Pontino, Latina, Italy
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Comparison of microporous polysaccharide hemospheres and Ankaferd Blood Stopper in a rabbit epistaxis model. Eur Arch Otorhinolaryngol 2015; 273:933-8. [PMID: 26100031 DOI: 10.1007/s00405-015-3692-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 06/16/2015] [Indexed: 10/23/2022]
Abstract
The aim of this study was to evaluate the histopathological impact, effectiveness, and safety of two hemostatic agents, Ankaferd Blood Stopper (ABS) and microporous polysaccharide hemospheres (MPH), in an experimental rabbit epistaxis model. Rabbits were randomly assigned, using a computerized random number generator, to the following three groups of six animals: group 1 (control, irrigated with saline); group 2 (ABS-treated); and group 3 (MPH-treated). In all groups, a standardized rabbit epistaxis model was used. Hemostasis time and extent of nasal bleeding were measured to compare the hemostatic effect of ABS and MPH among groups. Septums were removed for histopathological analysis, 7 days after the procedure. ABS reduced hemostasis time to 104.2 s and amount of bleeding to 20.5 mg. MPH reduced hemostasis time to 71.7 s and amount of bleeding to 11.5 mg. Mean bleeding time in wounds administered ABS and MPH was significantly shorter compared with wounds administered isotonic saline solution (p = 0.004). ABS and MPH application decreased bleeding significantly compared with the control group (p = 0.004). Bleeding time and amount in the MPH group was significantly reduced compared with the ABS group (p = 0.013 and p = 0.004, respectively). There was no significant difference in the histopathological evaluation results between the ABS, MPH, and control groups. Our data indicate that both ABS and MPH represent safe, effective, and fast-acting hemostatic agents in the management of epistaxis. MPH was more effective than ABS in terms of hemostasis time and amount of bleeding.
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