Long-term outcomes of a chitosan hemostatic dressing in laparoscopic partial nephrectomy

This study examined the long-term safety and effectiveness of a chitosan hemostatic dressing (CHD) in a porcine laparoscopic partial nephrectomy (LPN) model. Eighteen miniswine underwent treatment of using CHD or Surgicel(®) and Tisseel(®) (S/T) for renal parenchymal hemostasis after LPN. The animals were followed up for 6 and 12 months. Surgical procedure related complications, hematological and blood chemical changes were monitored. Histopathological examination was performed on the treated and untreated tissue and organs. All animals had initial hemostasis and survived without any immediate or delayed complications in both CHD and S/T groups. The animals with CHD treatment left large amounts of chitosan residuals on the resected kidney that associated with greater inflammatory scores when compared to the S/T treated animals. This long-term study showed that CHD residuals remained for 12 months and resulted in local inflammation in the LPN model. Despite lack of signs and symptoms of clinical significance in the animals, a further investigation should be conducted to understand the risk of slow degradation of CHD.