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Effectiveness of microporous polysaccharide hemospheres for achieving hemostasis in mohs micrographic surgery
Stephen R Tan1, Whitney D Tope
1Division of Dermatologic Surgery, Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA. srtan@iupui.edu
Background:
Microporous polysaccharide hemospheres consist of controlled-porosity spherical particles manufactured from bioinert plant polysaccharide. Microporous polysaccharide hemospheres facilitate hemostasis by rapidly absorbing the fluid component of blood, concentrating platelets and clotting factors to accelerate blood clotting.
Objective:
The objective was to compare a microporous polysaccharide hemosphere bandage and electrocautery in achieving hemostasis.
Methods:
Twenty-four patients with a total of 48 stages of Mohs micrographic surgery were included. Patients were stratified by whether or not they were taking anticoagulant medications. Within each group, patients were randomized to receive either the microporous polysaccharide hemosphere bandage or electrocautery. Outcomes included bleeding through the dressing (early time point) and active bleeding upon dressing removal (late time point).
Results:
Nineteen patients not taking anticoagulants had 40 stages, of which 18 received the study bandage and 22 received electrocautery. The remaining 5 patients on anticoagulants had 8 stages, of which 4 received the study bandage and 4 received electrocautery. In both total and subgroup analysis, there was a higher incidence of bleeding through the dressing with the study bandage (p<0.05), but no increase in the incidence of active bleeding upon dressing removal (p>0.05).
Conclusion:
The microporous polysaccharide hemosphere study bandage had an increased incidence of bleeding through the dressing compared to electrocautery, but did not have an increased incidence of active bleeding upon dressing removal.
Insights
Microporous polysaccharide hemospheres (MPH) bandages increased early bleeding through dressings compared to electrocautery. However, MPH bandages did not increase active bleeding upon dressing removal, showing comparable hemostasis in Mohs surgery.
Area of Science:
- Dermatologic Surgery
- Hemostasis
- Biomaterials
Background:
- Microporous polysaccharide hemospheres (MPH) are bioinert particles designed to accelerate blood clotting.
- MPH absorb blood fluid, concentrating clotting factors for hemostasis.
Purpose of the Study:
- To compare the efficacy of MPH bandages versus electrocautery for hemostasis.
- Evaluate bleeding outcomes in patients undergoing Mohs micrographic surgery.
Main Methods:
- A randomized study involving 24 patients and 48 surgical stages.
- Patients were stratified based on anticoagulant medication use.
- Outcomes measured included bleeding through dressings and active bleeding at removal.
Main Results:
- MPH bandages showed a higher incidence of bleeding through dressings (p<0.05).
- No significant difference in active bleeding upon dressing removal was observed (p>0.05).
- Results were consistent across patients on and off anticoagulants.
Conclusions:
- MPH bandages are associated with increased superficial bleeding compared to electrocautery.
- MPH bandages provide comparable control of active bleeding at the surgical site.
- Further research may optimize MPH bandage application for improved hemostasis.
