Objective: A novel gelatin-based direct hemostatic agent that may provide local control of bleeding, even in the presence of coagulopathy, was evaluated for intraoperative hemostatic effectiveness and time needed to achieve hemostasis.
Methods: A gelatin matrix (GM) was used to control bleeding in patients undergoing surgery for the resection of abdominal or pelvic organ tumors. GM was applied directly to the area of bleeding to produce hemostasis. The severity of bleeding before and after application of GM was graded on a 4-point scale (1 = minimal, 2 = mild, 3 = moderate, 4 = severe). The time to achieve complete hemostasis was recorded.
Results: Thirty-five (35) female (age 61 + 9 years) and 47 male patients (age 61 + 12 years) were included in this study. The surgical procedures included are listed in the Table. Seventeen patients (21%) had preoperative coagulopathy resulting from coexistent cirrhosis. Bleeding severity scores for the first bleeding site treated with GM were: 2 (19/82 23%), 3 (61/82 75%) and 4 (2/82 2%). Bleeding was completely stopped after the use of GM in 80 cases and reduced to a score of 1 in 2 cases (98% complete cessation; 2% significantly reduced). The mean time to effectiveness was 1.9 + 0.5 min. On average 2.6 ml of GM was used per site of bleeding.
Conclusions: GM provided rapid and effective intraoperative control of mild to severe bleeding from the liver edge or other fields of surgical dissection in patients undergoing oncologic operations, even when patients had prolonged bleeding times resulting from cirrhosis.
Procedure Type Female (N) Male (N)
Liver Resection 21 36
Resection of Rectal Adenocarcinoma 7 3
Colon Resection 2 0
Resection of Pelvic Sarcoma 1 2
Gastric Resection 2 3
Pancreaticoduodenectomy 1 1
Other 1 2
Total 35 47