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Surgical sealant

Dilraj S Grewal, Tamer H Mahmoud
A 54-year-old male developed symptomatic scleral buckle exposure 16 years after placement and presented with large conjunctival defects with fibrosed edges. Following surgical removal of the buckle elements, primary conjunctival closure could not be achieved due to significant wound tension despite undermining the conjunctival edges to mobilize the conjunctiva. A dehydrated amniotic membrane graft (Ambio5; IOP Ophthalmics, Costa Mesa, CA) was placed on the scleral bed and secured in place with fibrin sealant (TISSEEL; Baxter International, Westlake Village, CA)...
October 1, 2016: Ophthalmic Surgery, Lasers & Imaging Retina
James Dana Kondrup, Frances R Anderson, Melanie Rose Katz
Biosurgical materials (biosurgicals) have a wide array of uses for providing hemostasis, including decreasing the risk of postoperative bleeding and, intraoperatively, controling bleeding. These materials are especially useful in situations where electrocautery, sutures, or clips are not feasible. Biosurgicals have long been used in general surgery and surgical subspecialties to provide hemostasis; however, they still are not commonly used during obstetric and gynecologic procedures. Three commonly used classes of biosurgicals will be discussed in this article: oxidized regenerated cellulose, flowables, fibrin sealants, and fibrin sealant patches...
October 6, 2016: Surgical Technology International
A C Rogers, L P Turley, K S Cross, M P McMonagle
BACKGROUND: Suture-hole bleeding in arterial anastomoses prolongs operating time and increases blood loss, particularly with the use of prosthetic grafts. Surgical sealants (such as fibrin) may be used as haemostatic adjuncts in vascular surgery. This is a systematic review and meta-analysis of published studies that investigated the utility of surgical sealants in arterial-to-prosthetic graft anastomoses. METHODS: A systematic review was undertaken of papers published until January 2015 on Embase, MEDLINE, PubMed, PubMed Central and Cochrane databases that analysed the use of surgical sealants as haemostatic adjuncts after arterial anastomoses...
October 7, 2016: British Journal of Surgery
Mitra Corral, Nicole Ferko, Andrew Hogan, Sarah S Hollmann, Gaurav Gangoli, Nadine Jamous, Jonathan Batiller, Richard Kocharian
BACKGROUND: Despite hemostat use, uncontrolled surgical bleeding is prevalent. Drawbacks of current hemostats include limitations with efficacy on first attempt and suboptimal ease-of-use. Evarrest(®) is a novel fibrin sealant patch that has demonstrated high hemostatic efficacy compared with standard of care across bleeding severities. The objective of this study was to conduct a hospital cost analysis of the fibrin sealant patch versus standard of care in soft tissue and hepatic surgical bleeding...
2016: ClinicoEconomics and Outcomes Research: CEOR
A S M Gilmour, A Welply, J G Cowpe, A D Bullock, R J Jones
Objective To investigate the self-reported confidence and preparedness of final year undergraduate students in undertaking a range of clinical procedures.Methods A questionnaire was distributed to final year dental students at Cardiff University, six months prior to graduation. Respondents rated their confidence in undertaking 39 clinical procedures using a 5-point scale (1 = can undertake on own with confidence, 5 = unable to undertake). Students also responded yes/no to experiencing four difficulties and to three statements about general preparedness...
September 23, 2016: British Dental Journal
Cord M Brundage, Rebecca A Packer, Matthew D Jones
OBJECTIVE: To describe the magnetic resonance (MR) image appearance of 5 hemostatic agents placed in the brain, and to review their clinical application. STUDY DESIGN: Descriptive ex vivo and in vivo study. ANIMALS: Canine cadavers (n=4), client-owned dogs (n=4). METHODS: Heads from 4 canine cadavers were used, each with 5 hemostatic agents placed in specific locations in the brain. Hemostatic agents were used in their native form in 2 cadaveric brains, and in 2 others the materials were saturated with fresh whole blood prior to placement to mimic application in a field of active hemorrhage...
September 23, 2016: Veterinary Surgery: VS
Devesh Jalan, Neginder Saini, Mohammad Zaidi, Alexandra Pallottie, Stella Elkabes, Robert F Heary
OBJECTIVE In acute traumatic brain injury, decompressive craniectomy is a common treatment that involves the removal of bone from the cranium to relieve intracranial pressure. The present study investigated whether neurological function following a severe spinal cord injury improves after utilizing either a durotomy to decompress the intradural space and/or a duraplasty to maintain proper flow of cerebrospinal fluid. METHODS Sixty-four adult female rats (n = 64) were randomly assigned to receive either a 3- or 5-level decompressive laminectomy (Groups A and B), laminectomy + durotomy (Groups C and D), or laminectomy + duraplasty with graft (Group E and F) at 24 hours following a severe thoracic contusion injury (200 kilodynes)...
September 16, 2016: Journal of Neurosurgery. Spine
Halil Coskun, Erkan Yardimci
BACKGROUND: Staple-line leakage and bleeding are worrisome and feared postoperative complications after laparoscopic sleeve gastrectomy (LSG) in morbidly obese patients. The purpose of this study was to review clinical evidence following the use of fibrin sealant in standard LSG. METHODS: Morbidly obese patients who underwent standard technique of LSG with using fibrin sealant were included in the study. Demographics variables [age, gender, body mass index (kg/m(2)), and comorbid conditions], the re-admission rate, and postoperative early complications, such as bleeding, staple-line leak, twist and stricture, were evaluated at the follow-up during the postoperative first month...
September 7, 2016: Surgical Endoscopy
Bart Falter, Johan Abeloos, Calix De Clercq, Nathalie Neyt, Philippe Lamoral, Gwen R J Swennen
PURPOSE: Transoral placement of bicortical screws is a rigid fixation method in orthognathic surgery that is used less often than transbuccal placement. The aim of this study was to examine the postoperative outcome of transoral bicortical screw insertion during orthognathic surgery and to compare it with the more common transbuccal fixation technique. MATERIALS AND METHODS: A retrospective cohort study was conducted. Clinical files of orthognathic surgery patients operated on from January 2010 through December 2012 were reviewed...
July 25, 2016: Journal of Oral and Maxillofacial Surgery
David Rowe, Scott Chambers, Amy Hampson, Hayden Eastwood, Stephen O'Leary
AIM: To determine whether the type of material used to seal the cochlea after round window cochlear implantation influences delayed hearing loss. BACKGROUND: Cochlear implants are now prescribed to patients with residual, low-frequency hearing. This hearing-which provides perceptual benefits for the implanted ear-is frequently lost for unknown reasons weeks to months after surgery in a proportion of patients. A post-surgical change in cochlear mechanics, related to the material used to seal the cochlea after round window implantation, may contribute to this loss...
September 2016: Otology & Neurotology
Luca Weltert, Salvatore D'Aleo, Ilaria Chirichilli, Mauro Falco, Franco Turani, Alessandro Bellisario, Ruggero De Paulis
OBJECTIVE: Hemostasis is a critical component of all surgical procedures and especially cardiac surgery. In addition to traditional means, topical hemostatic agents have been reported to be extremely effective in terminating bleeding during cardiac procedures. We compared a hemostatic matrix sealant agent (HEMOPATCH Baxter Healthcare Corporation, Deerfield, IL) with alternative topical hemostatic treatment in patients undergoing ascending aorta surgery with moderate bleeding. MATERIALS AND METHODS: Following sample size calculation, in a prospective randomized study design, 85 patients were treated with HEMOPATCH matrix sealant and 85 patients received alternative treatment (dry or wet gauze compression or similar [control group])...
July 29, 2016: Surgical Technology International
Adem Binnetoglu, Berat Demir, Ali Cemal Yumusakhuylu, Tekin Baglam, Murat Sari
Importance: Secondary posttonsillectomy bleeding associated with oozing from multiple sites or overcauterized tonsillar bed deserves special evaluation. Objective: To evaluate the use of an absorbable, flowable gelatin-thrombin hemostatic matrix (GTHM) sealant for secondary bleeding after tonsillectomy. Design, Setting, and Participants: This was a retrospective data analysis, with information gathered from medical records of pediatric patients with secondary posttonsillectomy bleeding treated with the GTHM between 2012 and 2016 at a referral center and a local satellite facility...
July 14, 2016: JAMA Otolaryngology—Head & Neck Surgery
Paweł Kroll, Anna Jażdżewska
OBJECTIVE: The aim of the study was to compare the results of the application of fibrin sealant and absorbable interrupted sutures and to evaluate the impact of the kidney wound closure method on the further development of the organ in young rats. MATERIALS AND METHODS: In 140 rats, a longitudinal bipolar incision of the renal parenchyma was made. In the study group the wound was closed using a fibrin sealant, whereas in the control group single absorbable sutures were applied to the renal parenchyma...
October 2016: Scandinavian Journal of Urology
Christoph Schimmer, Justus Gross, Elena Ramm, Björn-Carsten Morfeld, Grischa Hoffmann, Bernd Panholzer, Jürgen Hedderich, Rainer Leyh, Jochen Cremer, Rainer Petzina
OBJECTIVES: Surgical site infection (SSI) of the sternum is a devastating complication in cardiac surgery. The aim of this prospective randomized controlled two-centre clinical study was to compare the use of a gentamicin-collagen sponge (Genta-Coll® resorb) and of a cyanoacrylate-based microbial skin sealant (InteguSeal®) on the SSI rate of the sternum. METHODS: We analysed data from 996 consecutive patients following isolated coronary artery bypass grafting between 2012 and 2014...
June 29, 2016: European Journal of Cardio-thoracic Surgery
Ryo Mizuta, Temmei Ito, Tetsushi Taguchi
Surgical sealants are widely used clinically. Fibrin sealant is a commonly used sealant, but is ineffective under wet conditions during surgery. In this study, we developed surgical sealants composed of hydrophobically modified Alaska-pollock-derived gelatins (hm-ApGltns) with different alkyl chain lengths from C3 to C18 and a poly(ethylene)glycol-based 4-armed crosslinker (4S-PEG). The burst strength of the hm-ApGltns-based sealant was evaluated using a fresh porcine blood vessel and was found to increase with increasing alkyl chain length from 167±22 to 299±43mmHg when the substitution ratio of amino groups of ApGltn was around 10mol%...
October 1, 2016: Colloids and Surfaces. B, Biointerfaces
Tetsushi Taguchi, Mizuta Ryo, Temmei Ito, Keiko Yoshizawa, Mikio Kajiyama
A novel surgical sealant was developed by partially modifying the amino groups of Alaska pollock-derived gelatin derivative with cholesteryl groups (Chol-apGltn), which was combined with the crosslinker, pentaerythritol poly(ethylene glycol) ether tetrasuccinimidyl glutarate (4S-PEG). The burst strength of the resultant sealant was tested using fresh porcine aorta as an adherend. The Chol-apGltn/4S-PEG sealant cured within 25.4 ± 2.0 s. Burst strength increased with increasing degree of Chol modification up to a maximum value of 8...
January 2016: Journal of Biomedical Nanotechnology
Michael J Jarrett, Andres Vázquez-Torres, Daniel N Frank, Bruce D McCollister, Patrick K Henthorn, Diana Ir, Jeanelle Sheeder, Michael S Guy, Hiba Q Anwar, Kian Behbakht
Objective. Gelatin-thrombin matrix (GTM) tissue sealant use was previously identified as an independent predictor of pelvic infection following hysterectomies. We aim to elucidate contributing factors by assessing influence of GTM on bacterial colony formation and characterizing bacteria present at the vaginal cuff. Methods. Escherichia coli was incubated in phosphate-buffered saline (PBS) and pelvic washings with and without GTM to assess influence on colony formation. Pelvic washings of the vaginal cuff were collected from hysterectomies occurring from June through October 2015...
2016: Infectious Diseases in Obstetrics and Gynecology
Callum Wood, Cheryl Phillips
BACKGROUND: Surgical site infections (i.e. incisions that become infected) are a continuing concern in health care. Microbial sealant is a liquid that can be applied to the skin immediately before surgery and is thought to help reduce the incidence of surgical site infections (SSIs) by sealing in the skin flora, thus preventing contamination and infection of the surgical site. OBJECTIVES: To assess the effects of the preoperative application of microbial sealants (compared with no microbial sealant) on rates of SSI in people undergoing clean surgery...
2016: Cochrane Database of Systematic Reviews
Luis Jorge Cerezal-Garrido, Javier Agudo-Bernal, Carlos Vaquero-Puerta
INTRODUCTION: The purpose of our study was to compare the effect, on the inflammatory response and fibrosis formation, of four commercially available sealant products applied on an injured trachea in a Wistar rat population. MATERIALS AND METHODS: We compared four different sealants: cyanoacrylate, fibrin/thrombin, albumin/glutaraldehyde, and polyethylene glycol-based hydrogel (PEG). Rats were organized into six groups of similar size. Four of them were experimental, one was a baseline control group (BCG), and the sixth one was a reference control group (RCG)...
April 2016: Surgical Technology International
Jeff Henise, Brian R Hearn, Daniel V Santi, Hiroyuki Kamata, Takamasa Sakai, Gary W Ashley
We developed two types of polyethylene glycol (PEG)-based surgical sealants, which we have termed the PER and PRO series. In one, the PRO series, an 8-arm PEG containing activated carbonyl end-groups was reacted with a 4-armed amino-PEG. In the second, the PER series, a 4-arm PEG containing bi-functional end groups with four azides and four activated esters was reacted by strain-promoted alkyne-azide cycloaddition with a 4-arm cyclooctyne-PEG to give a near-ideal Tetra-PEG hydrogel. The sealants showed predictably tunable strength, swelling, adhesion, and gelation properties...
May 5, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
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