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Clinical Oral Investigations
Published in: Clinical Oral Investigations 4/2013

01-05-2013 | Original Article

In vivo hemostatic efficacy of polyurethane foam compared to collagen and gelatin

Authors: Ferdinand I. Broekema, Wim van Oeveren, Maaike H. A. Selten, Rolf J. H. Meijer, Joost T. M. de Wolf, Rudolf R. M. Bos

Published in: Clinical Oral Investigations | Issue 4/2013

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Abstract

Objectives

Topical hemostatic agents are used in all surgical disciplines. Most of these hemostats are based on animal-derived products like collagen and gelatin. They carry the potential risk of pathogen transmission. A newly developed biodegradable, fully synthetic hemostatic agent based on polyurethane foam (PU) with 55 % polyethylene glycol (PEG) would prevent these potential risks.

Materials and methods

The hemostatic efficacy of this new agent was compared to gelatin and collagen in humans who underwent extraction of an upper and lower molar (split-mouth model). After extraction of a molar in the maxilla and mandible, a PU foam and collagen or gelatin were inserted in the extraction socket for 2 min. Hereafter, the agents were removed and stored in ethylenediaminetetraacetic acid to stop coagulation. Then, the concentration of coagulation parameters thrombin–antithrombin III (TAT) complexes, fibrinogen, and thromboxane B2 (TxB2) in blood extracts from the agents was measured. The concentrations were also determined in baseline blood samples which were collected from the extraction socket.

Results

The concentrations of TAT and TxB2 were significantly increased, and fibrinogen concentration was significantly reduced compared to baseline wound blood concentrations indicating enhanced hemostasis. No significant differences were seen in the concentrations of these coagulation parameters in the three different hemostatic agents.

Conclusions

These results show that PU combined with 55 % PEG is a promising alternative for the animal-derived hemostatic agents.

Clinical relevance

The synthetic hemostatic agent could replace the animal-derived products like collagen and gelatin and therewith prevent the potential risk of pathogen transmission.
Literature
1.
Nemoto T, Horiuchi M, Ishiguro N, Shinagawa M (1999) Detection methods of possible prion contaminants in collagen and gelatin. Arch Virol 144(1):177–84PubMedCrossRef
2.
Lutolf MP, Hubbell JA (2005) Synthetic biomaterials as instructive extracellular microenvironments for morphogenesis in tissue engineering. Nat Biotechnol 23(1):47–55PubMedCrossRef
3.
van Minnen B, van Leeuwen MB, Kors G, Zuidema J, van Kooten TG, Bos RR (2008) In vivo resorption of a biodegradable polyurethane foam, based on 1,4-butanediisocyanate: a three-year subcutaneous implantation study. J Biomed Mater Res A 85(4):972–82PubMed
4.
Visscher SH, van Minnen B, van Leeuwen MB, van Kooten TG, Bos RR (2009) Closure of oroantral communications using biodegradable polyurethane foam: a long term study in rabbits. J Biomed Mater Res B 91(2):957–63
5.
Gorbet MB, Sefton MV (2004) Biomaterial-associated thrombosis: roles of coagulation factors, complement, platelets and leukocytes. Biomaterials 25(26):5681–703PubMedCrossRef
6.
Broekema FI, van Oeveren W, Zuidema J, Visscher SH, Bos RR (2011) In vitro analysis of polyurethane foam as a topical hemostatic agent. J Mater Sci Mater Med 22(4):1081–6PubMedCrossRef
7.
Furie B, Furie BC (2007) In vivo thrombus formation. J Thromb Haemost 1:12–17CrossRef
8.
Pelzer H, Schwarz A, Heimburger N (1988) Determination of human thrombin-antithrombin III complex in plasma with an enzyme-linked immunosorbent assay. Thromb Haemost 59(1):101–6PubMed
9.
Davie EW, Fujikawa K, Kisiel W (1991) The coagulation cascade: initiation, maintenance, and regulation. Biochemistry 30(43):10363–70PubMedCrossRef
10.
Kamath S, Blann AD, Lip GY (2001) Platelet activation: assessment and quantification. Eur Heart J 22(17):1561–71PubMedCrossRef
11.
Monroe DM, Hoffman M, Oliver JA, Roberts HR (1997) Platelet activity of high-dose factor VIIa is independent of tissue factor. Br J Haematol 99(3):542–7PubMedCrossRef
12.
Skarja GA, Brash JL (1997) Physicochemical properties and platelet interactions of segmented polyurethanes containing sulfonate groups in the hard segment. J Biomed Mater Res 34(4):439–55PubMedCrossRef
13.
Elwing H (1998) Protein absorption and ellipsometry in biomaterial research. Biomaterials 19(4–5):397–406PubMedCrossRef
14.
Thatte HS, Zagarins SE, Amiji M, Khuri SF (2004) Poly-N-acetyl glucosamine-mediated red blood cell interactions. J Trauma 57(1 Suppl):S7–12PubMedCrossRef
15.
Kanko M, Liman T, Topcu S (2006) A low-cost and simple method to stop intraoperative leakage-type bleeding: use of the vancomycin-oxidized regenerated cellulose (ORC) sandwich. J Invest Surg 19(5):323–7PubMedCrossRef
16.
Schonauer C, Tessitore E, Barbagallo G, Albanese V, Moraci A (2004) The use of local agents: bone wax, gelatin, collagen, oxidized cellulose. Eur Spine J 13(1):S89–96PubMedCrossRef
17.
18.
Hong YM, Loughlin KR (2006) The use of hemostatic agents and sealants in urology. J Urol 176(6 Pt 1):2367–74PubMedCrossRef
19.
Msezane LP, Katz MH, Gofrit ON, Shalhav AL, Zorn KC (2008) Hemostatic agents and instruments in laparoscopic renal surgery. J Endourol 22(3):403–8PubMedCrossRef
20.
Alexander JM, Rabinowitz JL (1978) Microfibrillar collagen (avitene) as a hemostatic agent in experimental oral wounds. J Oral Surg 36(3):202–5PubMed
21.
Wagner WR, Pachence JM, Ristich J, Johnson PC (1996) Comparative in vitro analysis of topical hemostatic agents. J Surg Res 66(2):100–8PubMedCrossRef
22.
Jorgensen LN, Lind B, Hauch O, Leffers A, Albrecht-Beste E, Konradsen LA (1990) Thrombin-antithrombin III-complex & fibrin degradation products in plasma: surgery and postoperative deep venous thrombosis. Thromb Res 59(1):69–76PubMedCrossRef
23.
Kannel WB, Wolf PA, Castelli WP, D'Agostino RB (1987) Fibrinogen and risk of cardiovascular disease: the Framingham study. JAMA 258(9):1183–6PubMedCrossRef
24.
Patrono C, Ciabattoni G, Pugliese F, Pierucci A, Blair IA, FitzGerald GA (1986) Estimated rate of thromboxane secretion into the circulation of normal humans. J Clin Invest 77(2):590–4PubMedCrossRef
25.
Albrechtsen OK, Thaysen JH (1955) Fibrinolytic activity in human saliva. Acta Physiol Scand 35(2):138–45PubMedCrossRef
Metadata
Title
In vivo hemostatic efficacy of polyurethane foam compared to collagen and gelatin
Authors
Ferdinand I. Broekema
Wim van Oeveren
Maaike H. A. Selten
Rolf J. H. Meijer
Joost T. M. de Wolf
Rudolf R. M. Bos
Publication date
01-05-2013
Publisher
Springer-Verlag
Published in
Clinical Oral Investigations / Issue 4/2013
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-012-0809-y

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