Pallaske F, Seebauer C, Kaltofen D, Dziomber S, Rudolph H, Schwanebeck U, Grählert X, Schulze G, Pallaske A, Boese-Landgraf J, Schlömann M, Daeschlein G
Medichema GmbH, Weststraße 57, 09112 Chemnitz, Germany.
Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, Walther-Rathenau Str. 42a, 17475 Greifswald, Germany.
J Visc Surg. 2021 Feb;158(1):11-18. doi: 10.1016/j.jviscsurg.2020.06.015. Epub 2020 Jul 31.
Despite ongoing optimisation of surgical techniques, hemostasis continues to be a fundamental challenge in many operations today. This randomised controlled trial compared the efficacy of a new hemostatic agent made of oxidised regenerated cellulose and collagen (ORC-Coll) with that of a conventional carrier-bound fibrin sealant (CBFS).
Hemostasis was investigated representatively in the case of post-thyroidectomy bleeding from the resection surface. To demonstrate that ORC-Coll (mediCipio® A) has at least the same hemostatic efficacy as CBFS (Tachosil®), the volume of drainage fluid at the time of drain removal was used as the primary endpoint in a non-inferiority test with a significance level of 5%. The secondary endpoints included number and size of hemostatic agents required, adhesion of the hemostatic agent to the bleeding surface, intraoperative hemostatic effect, duration of drainage and adverse events during a six-month follow-up period.
A total of 150 patients (ORC-Coll: 75; CBFS: 75) were included. After operation, total volume of drainage fluid was 68.20±44.56mL in the ORC group and 68.21±40.20mL in the CBFS group. The non-inferiority of ORC-Coll compared to CBFS with regard to hemostatic efficacy was shown at a significance level of 5%. The results demonstrated effectiveness in achieving hemostasis without adverse events.
ORC-Coll is an effective hemostatic agent and barrier sealant without blood components, which ensures reliable prevention of intra- and postoperative bleeding. With use of the new technique, any risks associated with the use of human blood components are a priori eliminated.
尽管手术技术不断优化,但止血仍是当今许多手术中的一项基本挑战。本随机对照试验比较了一种由氧化再生纤维素和胶原蛋白制成的新型止血剂(ORC-Coll)与传统载体结合纤维蛋白密封剂(CBFS)的疗效。
以甲状腺切除术后切除表面出血为例,对止血情况进行代表性研究。为证明ORC-Coll(mediCipio® A)具有至少与CBFS(Tachosil®)相同的止血效果,在一项显著性水平为5%的非劣效性试验中,将拔除引流管时的引流液量作为主要终点。次要终点包括所需止血剂的数量和大小、止血剂与出血表面的粘附情况、术中止血效果、引流持续时间以及六个月随访期内的不良事件。
共纳入150例患者(ORC-Coll组:75例;CBFS组:75例)。术后,ORC组的引流液总量为68.20±44.56mL,CBFS组为68.21±40.20mL。在5%的显著性水平下,显示出ORC-Coll在止血效果方面不劣于CBFS。结果表明其在实现止血方面有效且无不良事件。
ORC-Coll是一种有效的无血液成分的止血剂和屏障密封剂,可确保可靠预防术中及术后出血。采用新技术可预先消除与使用人类血液成分相关的任何风险。