A novel haemostatic agent based on self-assembling peptides in the setting of nasal endoscopic surgery, a case series

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A novel purely synthetic topical haemostatic agent is proposed for use in endonasal surgery.

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The mechanism is based on the self-assembling tendency of four repeating peptide sequences.

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The haemostatic agent was used in 60 patients undergoing endonasal powered turbinoplasty.

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Routine post-operative followup at 4 weeks has shown no re-bleeding or adhesion formation in all 60 patients.

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Pending further research, the agent shows promise in endonasal surgery as both a haemostatic and anti-adhesive adjunct.

Introduction

Recently, a novel purely synthetic topical haemostatic agent (PuraStat^®) has been proposed in surgery based on the self-assembling tendency of some repeating peptide sequences. This transparent, ready to use hydrogel appears suitable for use in FEES with low rates of post-operative re-bleeding and adhesion formation.

A first series of 60 patients experiencing endonasal powered turbinoplasty across various hospitals in Sydney using PuraStat^® was observed for postoperative re-bleeding and adhesion formation.

Discussion

In all 60 patients, no post-operative re-bleeding was observed, while healing went well in absence of adhesion formation. Effective haemostasis with PuraStat^® is well documented in other surgical fields, but its use in FEES and adhesion prevention is relatively novel.

Conclusion

Synthetic self-assembling peptides appear to be indicated in this area. Further studies are needed to confirm their potential for adhesion prevention.