Fingerhut Abe, Uranues Selman, Ettorre Giuseppe Maria, Felli Emanuele, Colasanti Marco, Scerrino Gregorio, Melfa Giusepina Irene, Raspanti Cristina, Gulotta Gaspare, Meyer Alexander, Oberhoffer Martin, Schmoeckel Michael, Weltert Luca Paolo, Vignolini Graziano, Salvi Matteo, Masieri Lorenzo, Vittori Guido, Siena Giampaolo, Minervini Andrea, Serni Sergio, Carini Marco
Section for Surgical Research, Department of Surgery Medical University of Graz Graz, Austria.
Clinical Division of General Surgery, Department of Surgery Medical University of Graz Graz, Austria.
Surg Technol Int. 2014 Nov;25:29-35.
Topical hemostatic agents that can seal tissues and assist in the coagulation cascade of patients undergoing surgery have been readily available for several decades. Using either synthetic or animal/plant-derived materials, these agents represent a powerful tool to reduce postoperative bleeding complications in cases where mechanical or energy-driven hemostasis is not possible or insufficient. Recently, a novel sealing hemostatic patch, HEMOPATCH (Baxter International, Deerfield, IL), was developed. The device is a thin and flexible patch consisting of a specifically-formulated porous collagen matrix, coated on one side with a thin protein-binding layer. This gives the patch a dual mechanism of action, in which the two components interact to achieve hemostasis by sealing off the bleeding surface and initiating the body's own clotting mechanisms. Here we present a series of case reports that outline the quick, effective hemostatic sealing of HEMOPATCH in a variety of clinical applications, including solid organ, gastrointestinal, biliopancreatic, endocrine, cardiovascular, and urologic surgeries. Essentially a feasibility study, these reports demonstrate how HEMOPATCH can be applied to seal almost any bleeding surface encountered during a range of procedures. Our results show that the device is eminently capable in both via laparotomy and laparoscopic approaches, and in patients with impaired coagulation or highly variable anatomies. In conclusion, our cases document the ease-of-use, application, and immediate hemostatic effect of the patch across a broad range of surgical settings and paves the way for future randomized clinical trials with more extensive follow-up.
几十年来,能够封闭组织并协助手术患者凝血级联反应的局部止血剂已广泛可得。这些止血剂使用合成材料或动物/植物衍生材料,是一种强大的工具,可在机械或能量驱动的止血方法不可行或不足的情况下减少术后出血并发症。最近,一种新型的密封止血贴片HEMOPATCH(百特国际公司,伊利诺伊州迪尔菲尔德)被研发出来。该装置是一种薄而灵活的贴片,由特殊配方的多孔胶原蛋白基质组成,一侧涂有一层薄的蛋白质结合层。这赋予了贴片双重作用机制,其中两种成分相互作用,通过封闭出血表面并启动人体自身的凝血机制来实现止血。在此,我们展示一系列病例报告,概述了HEMOPATCH在各种临床应用中的快速、有效止血密封效果,包括实体器官、胃肠道、胆胰、内分泌、心血管和泌尿外科手术。这些报告本质上是一项可行性研究,展示了HEMOPATCH如何应用于封闭一系列手术过程中遇到的几乎任何出血表面。我们的结果表明,该装置在开腹手术和腹腔镜手术中均表现出色,在凝血功能受损或解剖结构高度变异的患者中也能发挥作用。总之,我们的病例记录了该贴片在广泛手术环境中的易用性、应用方法和即时止血效果,为未来进行更广泛随访的随机临床试验铺平了道路。