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Surgical Endoscopy

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01-04-2011

Comparison of hemostatic properties between collagen and synthetic buttress materials used in staple line reinforcement in a swine splenic hemorrhage model

Authors: David Spector, Zvi Perry, Tracy Konobeck, Daniel Mooradian, Scott Shikora

Published in: Surgical Endoscopy | Issue 4/2011

Abstract

Introduction

The use of staplers in gastrointestinal surgery is widespread, especially in advanced laparoscopic procedures. Staple line reinforcement with a buttress reduces bleeding and associated complications through a combination of factors. The intrinsic hemostatic properties of buttress materials have not been examined. This study examined the intrinsic hemostatic properties of two different types of material used in buttressing in an accepted hemostasis model that does not involve stapling or its effects by compression.

Materials

An acellular collagen buttress (Veritas^®) and a synthetic polymer buttress (Duet™) were compared to two commonly used hemostatic agents, Syvek^® and Surgicel^®, with gauze as control.

Methods

In a swine capsular stripping hemostasis model, a 1 × 1 cm section of spleen capsule was removed and used as a source of bleeding, with one patch of material tested per bleeding site. A total of 51 wounds were created in five pigs (each patch n = 10, control n = 11). Hemostatic efficacy was assessed by quantitating the number of applications and total time needed for bleeding to stop.

Results

The mean time needed for hemostasis for Syvek^® and Veritas^® patches was significantly less than gauze, Duet™ and Surgicel^® (4.02, 4.51 vs. 8.97, 9.22, and 10.30 min respectively; p < 0.05). The Syvek^® and Veritas^® patches required significantly fewer applications than gauze, Duet™ and Surgicel^® (1.7, 2.2 vs. 4.1, 4.6, and 4.9 respectively; p < 0.01).

Conclusions

The intrinsic hemostatic properties of different buttressing materials vary widely. In this study, a collagen buttress was significantly better at promoting hemostasis than the synthetic buttress material in a nonstapling model. This could be another factor to consider when choosing a buttress for staple line reinforcement.

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Title: Comparison of hemostatic properties between collagen and synthetic buttress materials used in staple line reinforcement in a swine splenic hemorrhage model
Authors: David Spector
Zvi Perry
Tracy Konobeck
Daniel Mooradian
Scott Shikora
Publication date: 01-04-2011
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 4/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-010-1331-4

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Comparison of hemostatic properties between collagen and synthetic buttress materials used in staple line reinforcement in a swine splenic hemorrhage model

Abstract

Introduction

Materials

Methods

Results

Conclusions

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Abstract

Introduction

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Results

Conclusions

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