Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria.
HPB (Oxford). 2013 Jul;15(7):548-58. doi: 10.1111/hpb.12009. Epub 2012 Dec 27.
Bleeding during hepatic surgery is associated with prolonged hospitalization and increased morbidity and mortality. The Veriset™ haemostatic patch is a topical haemostat comprised of an absorbable backing made of oxidized cellulose and self-adhesive hydrogel components. It is designed to achieve haemostasis quickly and adhere to tissues without fixation.
A prospective, randomized, multicentre, single-blinded study (n = 50) was performed to compare the use of a Veriset™ haemostatic patch with a fibrin sealant patch (TachoSil(®) ) (control) in the management of diffuse bleeding after hepatic surgery. Patients were randomized following the confirmation of diffuse bleeding requiring the use of a topical haemostat. Time to haemostasis was assessed at preset intervals until haemostasis was achieved.
Both groups were similar in comorbidities and procedural techniques. The median time to haemostasis in the group using the Veriset™ haemostatic patch was 1.0 min compared with 3.0 min in the control group (P < 0.001; 3-min minimum application time for the control patch). This result was independent of bleeding severity and surface area. Both products had similar safety profiles and no statistical differences were observed in the occurrence of adverse or device-related events.
Regardless of bleeding severity or surface area, the Veriset™ haemostatic patch achieved haemostasis in this setting significantly faster than the control device in patients undergoing hepatic resection. It was safe and easy to handle in open hepatic surgery.
肝外科手术中的出血与住院时间延长以及发病率和死亡率增加有关。Veriset™止血贴是一种由氧化纤维素制成的可吸收背衬和自粘水凝胶组成的局部止血剂。它旨在快速止血,并在无需固定的情况下粘附于组织。
进行了一项前瞻性、随机、多中心、单盲研究(n=50),比较了 Veriset™止血贴与纤维蛋白密封剂贴(TachoSil®)(对照组)在肝外科手术后弥漫性出血管理中的应用。在确认需要使用局部止血剂的弥漫性出血后,对患者进行随机分组。在达到止血之前,以预设的时间间隔评估止血时间。
两组在合并症和手术技术方面相似。使用 Veriset™止血贴的组的中位止血时间为 1.0 分钟,而对照组为 3.0 分钟(P<0.001;对照组止血贴的最短应用时间为 3 分钟)。这一结果与出血严重程度和表面积无关。两种产品的安全性相似,在不良事件或器械相关事件的发生方面没有观察到统计学差异。
无论出血严重程度或表面积如何,在接受肝切除术的患者中,Veriset™止血贴在这种情况下的止血速度明显快于对照组器械。它在开放性肝外科手术中安全且易于操作。