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

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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.

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Acknowledgments

The authors gratefully acknowledge R. de Graaf, J. Jankie, and B.C. Bhat for the development and production of the PU sponges. We thank Dr. J.J.R. Huddleston Slater for his contribution to the study design.

Conflict of interest

This study was financially supported by Polyganics BV and the University Medical Center Groningen, The Netherlands.

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands

    Ferdinand I. Broekema, Maaike H. A. Selten, Rolf J. H. Meijer & Rudolf R. M. Bos

  2. Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Wim van Oeveren

  3. HaemoScan, Stavangerweg 23-23, 9723 JC, Groningen, The Netherlands

    Wim van Oeveren

  4. Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Joost T. M. de Wolf

Authors
  1. Ferdinand I. Broekema
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  2. Wim van Oeveren
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  3. Maaike H. A. Selten
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  4. Rolf J. H. Meijer
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  5. Joost T. M. de Wolf
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  6. Rudolf R. M. Bos
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Corresponding author

Correspondence to Ferdinand I. Broekema.

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Broekema, F.I., van Oeveren, W., Selten, M.H.A. et al. In vivo hemostatic efficacy of polyurethane foam compared to collagen and gelatin. Clin Oral Invest 17, 1273–1278 (2013). https://doi.org/10.1007/s00784-012-0809-y

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  • DOI: https://doi.org/10.1007/s00784-012-0809-y

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