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Montano-Pedroso JC, Rodrigues RDR, Perini FV, Oliveira LC, Donizetti E, Rizzo SRCP, Rabello G, Junior DML. Consensus of the Brazilian association of hematology, hemotherapy and cellular therapy on patient blood management: Intraoperative hemostasis and volume replacement. Hematol Transfus Cell Ther 2024; 46 Suppl 1:S32-S39. [PMID: 38582746 PMCID: PMC11069062 DOI: 10.1016/j.htct.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 02/18/2024] [Indexed: 04/08/2024] Open
Abstract
Hemostasis plays a critical role in surgical procedures and is essential for a successful outcome. Advances in hemostatic agents offer new approaches to controlling bleeding thereby making surgeries safer. The appropriate choice of these agents is crucial. Volume replacement, another integral part of Patient Blood Management (PBM), maintains adequate tissue perfusion, preventing cellular damage. Individualization in fluid administration is vital with the choice between crystalloids and colloids depending on each case. Colloids, unlike crystalloids, increase oncotic pressure, contributing to fluid retention in the intravascular space. Understanding these aspects is essential to ensure safe and effective surgery, minimizing complications related to blood loss and maintaining the patient's hemodynamic status.
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Affiliation(s)
- Juan Carlos Montano-Pedroso
- Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil; Instituto de Assistência Médica do Servidor Público Estadual (Iamspe), São Paulo, SP, Brazil
| | - Roseny Dos Reis Rodrigues
- Hospital Israelita Albert Einstein são Paulo, São Paulo, SP, Brazil; Faculdade de Medicina da Universidade de São Paulo (FM USP), São Paulo, SP, Brazil
| | - Fernanda Vieira Perini
- Grupo GSH - Gestor de Serviços de Hemoterapia, São Paulo, SP, Brazil; Associação Beneficente Síria HCOR, São Paulo, SP, Brazil
| | - Luciana Correa Oliveira
- Hemocentro de Ribeirão Preto, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP), Ribeirão Preto, SP, Brazil
| | | | | | - Guilherme Rabello
- Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (Incor - HCFMUSP), São Paulo, SP, Brazil.
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Abedi M, Shafiee M, Afshari F, Mohammadi H, Ghasemi Y. Collagen-Based Medical Devices for Regenerative Medicine and Tissue Engineering. Appl Biochem Biotechnol 2023:10.1007/s12010-023-04793-3. [PMID: 38133881 DOI: 10.1007/s12010-023-04793-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
Assisted reproductive technologies are key to solving the problems of aging and organ defects. Collagen is compatible with living tissues and has many different chemical properties; it has great potential for use in reproductive medicine and the engineering of reproductive tissues. It is a natural substance that has been used a lot in science and medicine. Collagen is a substance that can be obtained from many different animals. It can be made naturally or created using scientific methods. Using pure collagen has some drawbacks regarding its physical and chemical characteristics. Because of this, when collagen is processed in various ways, it can better meet the specific needs as a material for repairing tissues. In simpler terms, collagen can be used to help regenerate bones, cartilage, and skin. It can also be used in cardiovascular repair and other areas. There are different ways to process collagen, such as cross-linking it, making it more structured, adding minerals to it, or using it as a carrier for other substances. All of these methods help advance the field of tissue engineering. This review summarizes and discusses the current progress of collagen-based materials for reproductive medicine.
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Affiliation(s)
- Mehdi Abedi
- Pharmaceutical Science Research Center, Shiraz University of Medical Science, Shiraz, Iran.
- Research and Development Department, Danesh Salamat Kowsar Co., P.O. Box 7158186496, Shiraz, Iran.
| | - Mina Shafiee
- Research and Development Department, Danesh Salamat Kowsar Co., P.O. Box 7158186496, Shiraz, Iran
| | - Farideh Afshari
- Department of Tissue Engineering and Applied Cell Science, School of Advanced Medical Sciences and Technology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamidreza Mohammadi
- Research and Development Department, Danesh Salamat Kowsar Co., P.O. Box 7158186496, Shiraz, Iran
| | - Younes Ghasemi
- Pharmaceutical Science Research Center, Shiraz University of Medical Science, Shiraz, Iran
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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Wang DX, Wang YG, Ding GX, Li B, Liu RN, Ai ZW, Wang Y. The effectiveness of the puncture channel plugging for reduction of complications after CT-guided percutaneous transthoracic needle biopsy. Sci Rep 2023; 13:12318. [PMID: 37516777 PMCID: PMC10387056 DOI: 10.1038/s41598-023-38915-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 07/17/2023] [Indexed: 07/31/2023] Open
Abstract
The effect of plugging the puncture channel with a mixture of hemocoagulase injection on the complications of CT-guided percutaneous transthoracic need biopsy (PTNB) was discussed. The medical records of PTNB were retrospectively studied from June 2017 to May 2022. In the study, the puncture channel of 626 patients were blocked, while remain 681 patients' were not. The Mantel Haenszel method performed layered analysis and evaluated the correlation of adjusted confounding factors. The Odds Ratio and its 95% confidence interval were calculated using the Woof method. The incidence of high-level pulmonary hemorrhage was significantly reduced in patients with lesions ≤ 2 cm and different needle lengths. Patients with different pleural-needle tip angle and perineedle emphysema were blocked, and the incidence of pneumothorax and thoracic implants was significantly reduced. Through puncture channel plugging, the incidence of pulmonary hemorrhage, pneumothorax and thoracic catheterization of PTNB under CT guidance was reduced.
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Affiliation(s)
- Dong-Xu Wang
- Medical Imaging Center, the Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, 161006, Heilongjiang, China.
| | - Yu-Guang Wang
- Medical Imaging Center, the Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, 161006, Heilongjiang, China
| | - Guo-Xu Ding
- Medical Imaging Center, the Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, 161006, Heilongjiang, China
| | - Bo Li
- Medical Imaging Center, the Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, 161006, Heilongjiang, China
| | - Rui-Nan Liu
- Medical Imaging Center, the Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, 161006, Heilongjiang, China
| | - Zhong-Wei Ai
- Department of Pathology, Qiqihar Medical University, Qiqihar, 161006, Heilongjiang, China
| | - Yang Wang
- Medical Imaging Center, the Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, 161006, Heilongjiang, China
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Zuccatosta L, Latini MA, Mei F, Bonifazi M, Barisione E, Salio M, Gasparini S, Gonnelli F. A lymph node mediastinal foreign body reaction mimicking nodal metastasis: A case series. Front Med (Lausanne) 2022; 9:1014617. [PMID: 36213673 PMCID: PMC9537557 DOI: 10.3389/fmed.2022.1014617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction In the last decades, many haemostatic substances included oxidized cellulose topically applied have been used during surgery and their use have become a common practice. Oxidized cellulose (OC) is one of the most used haemostatic substances. However, different studies have shown the persistence of OC deposits after surgical procedures that may simulate recurrent malignancies and abscesses. We present a case series of patients with enlarged on CT and PET-FDG positive lymphadenopathies due to foreign body inflammatory reaction to OC after lung surgery for pulmonary malignancies. Methods Retrospective chart review of patients from 2021 to 2022 who underwent EBUS-TBNA for the characterization of hilar and/or mediastinal lymphadenopathies and a histopathological diagnosis of foreign body inflammatory reaction to OC. Results Eight patients were referred to "Ospedali Riuniti di Ancona" (n = 7) and "Ospedale San Martino" (Genoa) (n = 1) Interventional Pulmonology Units for the characterization of hilar and/or mediastinal lymphadenopathies. All the evaluated patients underwent surgical procedures for lung cancers within the previous 12 months. EBUS-TBNA was performed in all the patients to rule out nodal metastasis. The cyto-pathological evaluation revealed amorphous acellular eosinofilic material surrounded by inflammatory reaction. As no other apparent causes might explain this finding and considering the temporal relationship between the lymphadenopathy and the lung surgery, foreign body inflammatory reaction to OC is the most likely cause of the phenomenon. Conclusion In patients who underwent surgery for lung cancer, especially within few months, the development of lymph node foreign body reaction due to surgical material retention should always be considered.
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Affiliation(s)
- Lina Zuccatosta
- Pulmonary Diseases Unit, Azienda Ospedali Riuniti, Ancona, Italy
| | | | - Federico Mei
- Pulmonary Diseases Unit, Azienda Ospedali Riuniti, Ancona, Italy
- Polytechnic University of Marche, Ancona, Italy
| | - Martina Bonifazi
- Pulmonary Diseases Unit, Azienda Ospedali Riuniti, Ancona, Italy
- Polytechnic University of Marche, Ancona, Italy
| | | | - Mario Salio
- Pulmonary Diseases Unit, Ospedale Ss. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Stefano Gasparini
- Pulmonary Diseases Unit, Azienda Ospedali Riuniti, Ancona, Italy
- Polytechnic University of Marche, Ancona, Italy
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Topical hemostatic agents in neurosurgery, a comprehensive review: 15 years update. Neurosurg Rev 2021; 45:1217-1232. [PMID: 34734343 DOI: 10.1007/s10143-021-01684-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/26/2021] [Accepted: 10/25/2021] [Indexed: 12/30/2022]
Abstract
Hemostasis in neurosurgery is of utmost importance. Bleeding management is one of the crucial steps of each neurosurgical procedure. Several strategies, namely thermal, mechanical, electric, and chemical, have been advocated to face blood loss within the surgical field. Over time, countless hemostatic agents and devices have been proposed. Furthermore, the ever-growing recent technological innovation has made available several novel and interesting tools. Pursuant to their impact on surgical practice, we perceived the imperative to update our previous disclosure paper. Therefore, we reviewed the literature and analyzed technical data sheets of each product in order to provide an updated and comprehensive overview in regard to chemical properties, mechanisms of action, use, complications, tricks, and pitfalls of topical hemostatic agents.
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Paternò VA, Bisin A, Addis A. Comparison of the efficacy of five standard topical hemostats: a study in porcine liver and spleen models of surgical bleeding. BMC Surg 2020; 20:215. [PMID: 32977788 PMCID: PMC7519517 DOI: 10.1186/s12893-020-00874-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/20/2020] [Indexed: 11/19/2022] Open
Abstract
Background Several topical hemostats are available to help control surgical bleeding. Cutanplast is a highly absorbent and porous gelatin product that is available in Fast sponge and powder forms. This study investigated the hemostatic efficacy of Cutanplast Standard and Fast gelatin sponge and powder and Emosist oxidized regenerated cellulose (ORC) gauze in porcine liver and spleen surgical bleeding models. Methods Cutanplast Standard and Fast gelatin sponge and Emosist ORC gauze were tested in liver abrasion/incision, liver puncture and spleen incision/puncture injuries, and Cutanplast Standard and Fast gelatin powder products were tested in liver abrasion/incision injuries. There were 13 liver injury (five abrasion, five incision and three puncture) and six spleen injury (three puncture and three incision sites) sites per animal. Results Rapid hemostasis (≤ 2–5 min) was achieved in the liver abrasion and incision models with all Cutanplast gelatin sponge and powder products and Emosist ORC gauze, except in the liver incision model, time to hemostasis was > 5 min with Cutanplast Standard gelatin powder and Emosist ORC gauze. Rapid hemostasis occurred with Cutanplast Fast gelatin sponge and Emosist ORC gauze in the liver puncture and spleen puncture and incision models. In the spleen incision model, Cutanplast Standard gelatin sponge had a time to hemostasis approaching 10 min. Conclusion Cutanplast gelatin sponge and powder products and Emosist ORC gauze may be suitable for surgical applications involving parenchymal organ bleeding, but certain products may perform better than others, including Cutanplast gelatin powder in diffuse mild bleeding (such as liver abrasion), and Cutanplast Fast gelatin sponge and Emosist ORC gauze for splenic bleeding.
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Suchý P, Paprskářová A, Chalupová M, Marholdová L, Nešporová K, Klusáková J, Kuzmínová G, Hendrych M, Velebný V. Composite Hemostatic Nonwoven Textiles Based on Hyaluronic Acid, Cellulose, and Etamsylate. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E1627. [PMID: 32244805 PMCID: PMC7178357 DOI: 10.3390/ma13071627] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/26/2020] [Accepted: 03/28/2020] [Indexed: 12/25/2022]
Abstract
The achievement of rapid hemostasis represents a long-term trend in hemostatic research. Specifically, composite materials are now the focus of attention, based on the given issues and required properties. In urology, different materials are used to achieve fast and effective hemostasis. Additionally, it is desirable to exert a positive influence on local tissue reaction. In this study, three nonwoven textiles prepared by a wet spinning method and based on a combination of hyaluronic acid with either oxidized cellulose or carboxymethyl cellulose, along with the addition of etamsylate, were introduced and assessed in vivo using the rat partial nephrectomy model. A significantly shorter time to hemostasis in seconds (p < 0.05), was attributed to the effect of the carboxymethyl cellulose material. The addition of etamsylate did not noticeably contribute to further hemostasis, but its application strengthened the structure and therefore significantly improved the effect on local changes, while also facilitating any manipulation by the surgeons. Specifically, the hyaluronic acid supported the tissue healing and regeneration, and ensured the favorable results of the histological analysis. Moreover, the prepared textiles proved their bioresorbability after a three-day period. In brief, the fabrics yielded favorable hemostatic activity, bioresorbability, non-irritability, and had a beneficial effect on the tissue repair.
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Affiliation(s)
- Pavel Suchý
- Department of Human Pharmacology and Toxicology, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno 612 42, Czech Republic
| | - Alice Paprskářová
- Department of Human Pharmacology and Toxicology, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno 612 42, Czech Republic
| | - Marta Chalupová
- Department of Human Pharmacology and Toxicology, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno 612 42, Czech Republic
| | | | | | - Jarmila Klusáková
- Department of Human Pharmacology and Toxicology, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno 612 42, Czech Republic
| | - Gabriela Kuzmínová
- Department of Human Pharmacology and Toxicology, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno 612 42, Czech Republic
| | - Michal Hendrych
- Department of Physiology, Faculty of Medicine, Masaryk University, Brno 625 00, Czech Republic
- First Department of Pathology, St. Anne’s University Hospital and Faculty of Medicine, Masaryk University, Brno 656 91, Czech Republic
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