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The Journal of Cardiovascular Surgery 2000 Agosto;41(4):553-7

lingua: Inglese

Collagen patch coated with fibrin glue components. Treatment of suture hole bleedings in vascular reconstruction

Czerny M., Verrel F. *, Weber H. **, Müller N. ***, Kircheis L. ***, Lang W. **, Steckmeier B. *, Trubel W.

From the Department of Surgery Division of Vascular Surgery, University of Vienna, Vienna, Austria
*Department of Surgery, Ludwig-Maximilian University, Munich, Germany
**Department of Surgery University Erlangen, Germany
***Nycomed Pharma AG Nycomed Amersham, Roskilde, Denmark


Background. Bleeding ­from ­suture ­holes dur­ing vas­cu­lar recon­struc­tion, par­tic­u­lar­ly ­when poly­tet­ra­flu­o­roe­thy­lene (­PTFE) pros­the­ses are ­used, is ­still a prob­lem ­which can ­lead to intra­op­er­a­tive ­delay and ­increased ­blood ­loss. The aim of ­this pros­pec­tive, ran­dom­ised, ­open, con­trolled mul­ti­cen­tre ­study was to eval­u­ate wheth­er the use of a new ­local haem­os­typ­tic ­would ­reduce intra­op­er­a­tive ­blood ­loss and the ­time to hae­mos­ta­sis.
Methods. Thirty ­patients ­received a new haem­os­typ­tic (TachoComb H, Nycomed Pharma AG), where­as ­another 30 ­patients ­were treat­ed ­with com­press­es. The vas­cu­lar recon­struc­tions ­were ­either anas­to­mos­es or ­patch angio­plas­ties and ­were per­formed ­using ­PTFE vas­cu­lar pros­the­ses.
Results. The ­mean ­time to hae­mos­ta­sis of ­suture ­hole bleed­ing in the haem­os­typ­tic ­group (326.0 sec) was sig­nif­i­cant­ly short­er com­pared to the con­trol ­group (514.3 sec) (p=0.006). The ­median intra­op­er­a­tive ­blood ­loss was 24.5 g in the treat­ment ­group and 57.3 g in the con­trol ­group (p=0.045).
Conclusions. It was ­shown ­that col­la­gen patch­es coat­ed ­with com­po­nents of ­fibrin ­glue sig­nif­i­cant­ly ­reduce the ­time to hae­mos­ta­sis as ­well as ­blood ­loss at the oper­a­tion ­site in ­patients under­go­ing vas­cu­lar recon­struc­tion ­with ­PTFE ­grafts.

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