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Comparative in vitro analysis of topical hemostatic agents
W R Wagner1, J M Pachence, J Ristich
1Department of Surgery, University of Pittsburgh, Pennsylvania 15213, USA.
The Journal of Surgical Research
|December 1, 1996
Summary
Six common hemostatic agents were tested in vitro for their ability to promote clot formation. Collagen-based agents like Actifoam and Avitene demonstrated superior platelet interaction and clot initiation compared to gelatin and cellulose-based options.
Area of Science:
- Biomaterials Science
- Surgical Hemostasis
- Biomedical Engineering
Background:
- Hemostatic agents are crucial in surgery to control bleeding by aiding clot formation.
- Assessing the in vitro performance of these agents is vital for understanding their efficacy.
Purpose of the Study:
- To quantitatively compare the in vitro hemostatic capabilities of six commonly used agents.
- To evaluate their effects on platelet aggregation, deposition, activation, and gross clot formation.
Main Methods:
- In vitro testing of three collagen sponges (Actifoam, Helistat, Instat), microfibrillar collagen (Avitene), gelatin sponge (Gelfoam), and oxidized regenerated cellulose (Surgicel).
- Assays included platelet aggregation, platelet deposition via perfusion, platelet activation (ATP secretion), and whole blood clotting time.
Main Results:
- Agents that rapidly depleted platelets in perfusion (Avitene, Helistat, Actifoam) were most effective at inducing platelet aggregation and secretion.
- These agents also showed more rapid clot formation, indicating platelet dependency.
- An overall activity ranking was established: Actifoam ≈ Avitene > Helistat >> Gelfoam > Instat > Surgicel.
Conclusions:
- The in vitro performance ranking generally correlates with the base material (collagen > gelatin > cellulose) and processing methods.
- In vitro assessment provides a valuable screening tool for hemostatic agents prior to more extensive testing.