Centro de Transfusiones, Tejidos y Células de Sevilla (CTTS), Seville, Spain.
Cell Therapy and Cell Reprogramming Unit, GMP Network of the Andalusian Initiative for Advanced Therapies, Junta de Andalucia, Seville, Spain.
J Tissue Eng Regen Med. 2019 Apr;13(4):664-673. doi: 10.1002/term.2831. Epub 2019 Mar 20.
Blood loss remains a major concern during surgery and can increase the morbidity of the intervention. The use of topical haemostatic agents to overcome this issue therefore becomes necessary. Fibrin sealants are promising haemostatic agents due to their capacity to promote coagulation, but their effectiveness and applicability need to be improved. We have compared the haemostatic efficacy of a novel nanostructured fibrin-agarose hydrogel patch, with (c-NFAH) or without cells (a-NFAH), against two commercially available haemostatic agents in a rat model of hepatic resection. Hepatic resections were performed by making short or long incisions (mild or severe model, respectively), and haemostatic agents were applied to evaluate time to haemostasis, presence of haematoma, post-operative adhesions to adjacent tissues, and inflammation factors. We found a significantly higher haemostatic success rate (time to haemostasis) with a-NFAH than with other commercial haemostatic agents. Furthermore, other relevant outcomes investigated were also improved in the a-NFAH group, including no presence of haematoma, lower adhesions, and lower grades of haemorrhage, inflammation, and necrosis in histological analysis. Overall, these findings identify a-NFAH as a promising haemostatic agent in liver resection and likely in a range of surgical procedures.
失血仍然是手术中的一个主要关注点,并且会增加干预的发病率。因此,使用局部止血剂来解决这个问题是必要的。纤维蛋白粘合剂由于其促进凝血的能力而成为有前途的止血剂,但它们的有效性和适用性需要改进。我们比较了一种新型纳米结构纤维蛋白-琼脂糖水凝胶贴片(c-NFAH)或无细胞的纤维蛋白-琼脂糖水凝胶贴片(a-NFAH)与两种市售止血剂在大鼠肝切除模型中的止血效果。通过进行短切口或长切口(分别为轻度或重度模型)进行肝切除术,并应用止血剂来评估止血时间、血肿的存在、术后与相邻组织的粘连以及炎症因子。我们发现 a-NFAH 组的止血成功率(止血时间)显著高于其他商业止血剂。此外,在 a-NFAH 组中,其他相关的研究结果也得到了改善,包括没有血肿的存在、较低的粘连以及组织学分析中较低的出血、炎症和坏死程度。总的来说,这些发现表明 a-NFAH 是肝切除术以及可能在一系列手术中的一种有前途的止血剂。