| Popis: |
Introduction: We developed a complex porcine renal laceration model and tested the efficacy of a treatment regimen based on FLOSEAL gelatin matrix hemostatic sealant (Baxter Healthcare Corp, Fremont, CA). We evaluated the influence of preliminary renal vascular occlusion on hemostatic efficacy and the risk of urinoma formation after treatment. Methods: A total of 19 commercial swine a complex upper pole renal laceration via a 2 × 2 cm cruciate press instrument. The injury was uniformly produced on the left kidney. Subjects were randomized into 3 treatment groups. Experimental animals were treated with FLOSEAL gelatin matrix with (Group 1, n = 7) or without (Group 2, n = 6) preliminary renal vascular occlusion. Control subjects (Group 3, n = 6) were treated by a conventional sutured repair. Operative blood loss and time to hemostasis was compared between the groups. Abdominal CT scan was performed on each animal at 7 days. Results: Use of FLOSEAL gelatin matrix resulted in significantly less mean blood loss (Group 1—80.7 cc, Group 2—99.0 cc) versus conventional suture treatment (Group 3—191.8 cc, p = 0.036). Time to hemostasis was similarly reduced (Group 1—1.1 min, Group 2—2.5 min, Group 3—5.8 min, p = 0.009). Follow up CT scan revealed no evidence of significant perirenal fluid collections. Conclusions: FLOSEAL gelatin matrix hemostatic sealant provided effective hemostatic treatment after complex renal injury, both with and without preliminary vascular control. No delayed bleeding or urinoma formation was noted. |
