Comparison of absorbable materials for surgical haemostasis

Br J Surg. 1988 Oct;75(10):969-71. doi: 10.1002/bjs.1800751010.

Abstract

The haemostatic effect of two new materials has been compared with surgical gauze and oxidized cellulose using a standardized liver laceration in New Zealand White rabbits. Following excision of a 3 cm2 disc of tissue from the liver, 42 rabbits were randomized to the use of gauze swabs (n = 6), oxidized cellulose (Surgicel) (n = 12), porcine collagen (Medistat) (n = 12) or calcium alginate (Kaltostat) (n = 12) to control the resulting haemorrhage. Blood loss and time to haemostasis were accurately recorded. The absorbable materials were left in situ and animals killed between 2 weeks and 6 months later to examine speed of absorption and resulting adhesions. Calcium alginate stopped bleeding in less than 3 min in all animals compared with a mean (+/- s.e.m.) of 5.7 +/- 0.75 min for porcine collagen, 12.5 +/- 0.9 min for oxidized cellulose and greater than 15 min with gauze (P less than 0.001). Oxidized cellulose and calcium alginate reabsorbed within 3 months leaving a fibrous scar, but a vigorous foreign body reaction was seen with porcine collagen which caused intestinal obstruction in 5 out of 12 animals within 3 months.

Publication types

  • Comparative Study

MeSH terms

  • Absorption
  • Alginates
  • Animals
  • Cellulose, Oxidized
  • Collagen
  • Glucuronic Acid
  • Hemorrhage / pathology
  • Hemorrhage / physiopathology*
  • Hemostasis, Surgical*
  • Hexuronic Acids
  • Liver / pathology
  • Liver Diseases / pathology
  • Liver Diseases / physiopathology*
  • Rabbits
  • Random Allocation
  • Surgical Equipment*
  • Time Factors

Substances

  • Alginates
  • Cellulose, Oxidized
  • Hexuronic Acids
  • Glucuronic Acid
  • Collagen