Use of gelatin powder added to rifamycin versus bone wax in sternal wound hemostasis after cardiac surgery.
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Bone wax is the substance which has been used for hemostasis in different surgical fields for up to one hundred years and historically used in our center to prevent sternal bleeding and subsequent complications. Recently, reabsorbable gelatin powder has come into use. Up to now there are no clinical studies that compare these two substances. Between 1st January and 31st December 2004, 1249 subsequent patients have been operated on for different cardiac surgical procedures in our center, of them 557 were enrolled in a randomized perspective monocentric study. They have been divided into two similar subgroups: one treated with swine gelatin plus rifamycin (group one) and the other with bone wax (group two). The two hemostatic products have been applied just after the sternotomy and before the chest closing. Each patient was evaluated for bleeding, sternal infections and was followed-up for two months for bone and wound healing. Postoperative bleeding at the tenth hour was 315 ml+/-269 (mean+/-S.D.) in the first group and 395 ml+/-265 in the second (P<0.001). In the 10th-20th hour interval time bleeding was 120 ml+/-74 and 205 ml+/-132, respectively (P<0.001). Total bleeding was 415 ml+/-87 in group one and 580 ml+/-150 in group two (P<0.001). Chest reopening for bleeding not due to surgical problems was carried out in 14 patients (4.7%) (group one) and 19 (7.3%) (group two) (n.s.). Superficial sternal wound infection occurred in two patients (0.7%) in group one and three patients (1.1%) in group two (n.s.). There were no deep sternal wound infections. Bleeding was significantly higher in patients treated with bone wax compared to those with absorbable gelatin plus rifamycin. (+info)
Hemoperitoneum caused by hepatic necrosis and rupture following a snakebite: a case report with rare CT findings and successful embolization.
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We report the computed tomographic and angiographic findings in the case of a recently obtained successful clinical outcome after embolization of the hepatic artery in the case of a snakebite causing hemoperitoneum associated with hepatic necrosis and rupture with active bleeding. (+info)
Development of foreign body giant cells in response to implantation of Spongostan as a scaffold for cartilage tissue engineering.
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Spongostan, a gelatinous haemostatic sponge, is used in surgery. Moreover, Spongostan may serve as a scaffold for proteins or cells implanted into defects. At the site of biomaterial implantation, foreign body giant cells (FBGCs) may develop which are responsible for Spongostan degradation. The purpose of the present study was to examine whether Spongostan may serve as a scaffold in allogenic grafting of chondrocytes developed from rabbit auricular cartilage. The obtained results indicate that Spongostan fulfils its function as a cell scaffold, induces no inflammatory reaction and involves development of foreign body giant cells which participate in the process of its degradation. Microscopic observation showed that FBGCs manifest presence of cytoplasmic projections and lysosomes, which participate in phagocytosis of the applied scaffold. (+info)
Comparison of autogenous bone graft donor site haemostatic agents used in spinal surgery.
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