Using the new hemostatik gelatin Gelita-Spon Rapid3 to treat parenchymatous organs
Peter Hromádka, J. Škach
Klíčová slova: gelatin, Gelita-Spon Rapid3, parenchymatous organs
Anotace: Parenchymatous organs are characterized by high blood perfusion. Although large veins can easily be ligated, problems arise with capillary bleeding from these organs, particularly in cases such as bleeding from the sinusoidal structures of a liver (1). Surgeries performed on parenchymatous organs, both elective resections and traumatological surgeries, pose the risk of blood loss. Surgeons must minimize the risk of blood loss in order to maintain the hemodynamic stability of patients using the least possible volume of blood derivatives. It has been proven that the application of a blood derivative affects the immune status of patients (2), increases the risk of postoperative infections (3) and has a negative effect on the potential recurrence of oncological diseases (3). Bleeding from parenchymatous organs is usually stopped by surgical injection or resection of malacic tissue. Today, surgeons must employ precise surgical skills and modern instrumentation; on top of that, they should also have access to up-to-date local hemostatics and be familiar with them. In general, there are two groups of local hemostatics: on one side products based on oxidized cellulose and gelatine; and on the other, products containing procoagulant factors. The efficiency of the first group of products is ensured by the natural capacity of gelatine and oxycellulose to activate hemostasis and absorb fluids on a capillary level and through the special structure of their surfaces. Randomized controlled studies based on an animal model proved a higher efficiency of bovine collagen over oxycellulose and equine collagen (4). Bovine collagen has been demonstrated to induce a milder inflammatory response of the organism (4). The products of the latter type carry procoagulant factors such as thrombin or fibrinogen that directly activate hemocoagulation cascade. These two types show different levels of efficiency as well as having a significant difference in cost-effectiveness. Of course, the benefit to the patient is the most important criterion for using either of them. But in order to ensure this benefit, surgeons must have personal experience with an extensive portfolio of local hemostatics and be able to select products with the appropriate indication.
Citace: HROMÁDKA, Peter a J. ŠKACH. Using the new hemostatik gelatin Gelita-Spon Rapid3 to treat parenchymatous organs: a clinical observation. Rozhledy v chirurgii: měsíčník Československé chirurgické společnosti pro tvorbu domácí a rozhledy po chirurgii zahraniční. Praha: Česká lékařská společnost J.E. Purkyně, 2015, 94(5), 221 - 223. ISSN 0035-9351.