Acute in-vivo evaluation of bleeding with Gelfoam plus saline and Gelfoam plus human thrombin using a liver square lesion model in swine.

BACKGROUND: Management of post-operative bleeding has historically used topical bovine thrombin. However, possible harm through activation of coagulation inhibitors has encouraged investigation with other hemostatic agents. This study utilized a novel ordinal bleeding model to test whether a Gelfoam + human thrombin solution is superior at controlling bleeding when compared to Gelfoam + saline solution at different time intervals. STUDY DESIGN: Four swine underwent open laparotomy after receiving unfractionated heparin. Twenty open liver biopsies were performed in each swine; ten biopsies treated with Gelfoam + human thrombin solution and 10 biopsies treated with Gelfoam + saline solution. Three, 6 min, and 12 min after the procedure, bleeding was objectively graded by a four-point model. RESULTS: There was a significant (P < 0.017), treatment effect on each success/failure outcome (success = bleeding score

Duke Scholars

Author Victor Hasselblad Biostatistics & Bioinformatics, Division of Biostatistics

Author Jeffrey Harold Lawson Surgery, Vascular and Endovascular Surgery