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Results for “Gelatin Sponge, Absorbable”

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At least 55 records · Page 3Linked to original sources
PubMed1978

Esophagogastric variceal hemorrhage: its treatment by percutaneous transephatic coronary vein occlusion.

The angiographic technique percutaneous transhepatic coronary vein occlusion was used to treat esophagogastric variceal bleeding in 38 patients. There were two categories of patients: those actively bleeding who had not been controlled by continuous vasopressin infusion and/or Blakemore tube tamponade, and those with portal hypertension who were not actively bleeding at the time of transhepatic portal venography but who were at high risk for recurrent variceal hemorrhage. Coronary vein occlusion was achieved in 33 patients by (1) metal clip and cotton devices(one); (2) balloon catheter occlusion (two); (3) heat-treated autogenous clot and powdered absorbable gelatin sponge (Gelfoam) (13); and (4) Gelfoam strips soaked in sodium tetradecyl sulfate (17). Percutaneous coronary vein occlusion was effective in controlling 81% of the patients with actively bleeding varices. In patients who were not actively bleeding, percutaneous transhepatic coronary vein occlusion seemed to afford good protection for recurrent variceal hemorrhage.

Coronary Vessels↗
PubMed2000

Prevention of suture hole bleeding using fibrin sealant: benefits of factor XIII.

BACKGROUND: Suture hole bleeding is a frequent complication in vascular surgery. The use of fibrin sealants (FSs) during surgery is reported to reduce blood loss by enhancing hemostasis. OBJECTIVES: Using a pig vascular graft model we investigated: (1) the use of FSs in vascular surgery and measured blood loss with and without the use of FSs; (2) the effect of factor XIII in FSs on hemostasis and blood loss; and (3) the effect of increasing FS incubation time on hemostasis and blood loss. MATERIALS AND METHODS: During surgery, a 3-cm incision was made in the carotid artery wall. Incisions were covered with a Gore-Tex (PTFE) patch sutured with Ethicon monofil 5/0 or 3/0. The resulting suture holes were treated according to study protocol. Study 1: Nine pigs received either FS treatment (n = 5) or no treatment (n = 4). Study 2: Twenty pigs underwent bilateral surgery; right (n = 20) and left (n = 20) patches received either FS with factor XIII (FS + FXIII) or FS depleted of factor XIII (FS - FXIII). Study 3: Bilateral surgery was carried out on 24 pigs; PFTE patches secured with Ethicon 3/0 were treated with FS and allowed to polymerize for 120 s (n = 12), 180 s (n = 12), or 240 s (n = 12) or with solid support/thrombin (n = 12). RESULTS: Study 1: Mean blood loss was significantly lower in the FS-treated group compared with untreated controls (9.2 +/- 10.6 mL vs 178.8 +/- 125.5 mL, mean +/- SD, P = 0.016). Study 2: Significantly less blood was lost in the FS + FXIII group than in the FS - FXIII group (Delta = 9.6 mL, P = 0. 02). Study 3: Blood loss was significantly higher from patches treated with solid support/thrombin compared with those treated with FS (P < 0.01). CONCLUSIONS: FSs containing factor XIII, such as Beriplast P, are effective in reducing suture hole bleeding and improving hemostasis during vascular graft procedures. The presence of factor XIII contributes to the efficacy of FSs and reduces the time to hemostasis. During vascular surgery, blood loss can be reduced significantly by the use of fibrin sealant compared with absorbable gelatin sponges coated with thrombin.

Animals↗
PubMedDate not supplied

Transcatheter embolization of traumatic renal arteriovenous fistula.

An iatrogenic renal arteriovenous fistula was treated by transcatheter embolization with particles of absorbable gelatin sponge. Recurrent massive hematuria was successfully controlled. The procedure was easily accomplished with minimal loss of renal parenchyma. Surgery, which usually requires partial or total nephrectomy, was avoided.

Adult↗
PubMed1976

Treatment of uncontrolled hypertension by therapeutic renal infarction.

Certain hemodialysis patients need to be made anephric, either surgically or physiologically. Bilateral renal infarction with shredded absorbable gelatin sponge (Gelfoam) was performed on a woman with malignant hypertension being maintained on chronic center dialysis who was too great a surgical risk for bilateral nephrectomy. Peripheral embolization complicated the procedure resulting in a forefoot amputation for dry gangrene two months later. Her postinfarction peripheral plasma renins remained elevated, and she remained hypertensive but was more easily managed with fewer drugs. This technique has been successfully used by others in 1 patient with chronic renal failure and heavy proteinuria and another with hypertension and a solitary kidney. If, as in our case, postinfarction plasma renins remain elevated and hypertension persists, bilateral nephrectomy could be performed at a later date or infarction could be repeated.

Adult↗
PubMed1992

Osseous regeneration in the presence of four common hemostatic agents.

The iliac crest is a common site for bone procurement in oral and maxillofacial surgery. The goal of this study was to evaluate the potential for bone regeneration in the presence of four common hemostatic agents in a manner that parallels iliac bone procurement in humans. The agents evaluated were 1) Avitene (microfibrillar collagen; Medchem Products, Inc, Woburn, MA); 2) bone wax (beeswax with isopropyl palmitate; Ethicon, Inc, Somerville, NJ); 3) Gelfoam (absorbable gelatin sponge; The Upjohn Company, Kalamazoo, MI); and 4) Surgicel (oxidized regenerated cellulose; Johnson & Johnson Products, Inc, Patient Care Division, New Brunswick, NJ). Five surgical defects in each of four dogs were created for placement of the four materials; one defect served as an empty control site. The dogs were then allowed to heal over a 2-month period. Radiographic and histologic examination showed new bone formation in the presence of Avitene, Surgicel, and Gelfoam. Residual material incorporated in bone, without foreign-body response, was noted in the Avitene and Gelfoam sites. Bone wax, however, showed an intense foreign-body reaction, characterized by giant cells, plasma cells, fibrous granulation tissue, and lack of bone reformation. On the basis of these initial findings, it was concluded that Surgicel, Avitene, and Gelfoam may be adequate hemostatic agents for use in iliac bone procurement, whereas the use of bone wax appears to be contraindicated.

Animals↗
PubMedDate not supplied

Treatment of carcinoid liver metastases by hepatic-artery embolisation.

Two patients with multiple hepatic carcinoid metastases experienced considerable symptomatic relief after the hepatic artery was embolised with fragments of absorbable gelatin sponge administered through a percutaneous arterial catheter. With adequate pharmacological cover the technique is a safe, effective, and relatively painless treatment for a condition which is usually very difficult to manage.

Adult↗
PubMed1996

Effect of decalcified freeze-dried bone allograft on the healing of jaw defects after cyst enucleation.

PURPOSE: This study radiographically evaluated the changes that occur in jaw defects after enucleation of cysts and either grafting with demineralized freeze-dried bone allograft (DFDBA) or packing with absorbable gelatine sponge (Gelfoam). PATIENTS AND METHODS: Thirty-two patients (14 males, 18 females) with cystic lesions of the jaws were divided into two groups. Group A underwent enucleation and bone grafting with DFDBA. Group B underwent enucleation and packing with Gelfoam. Both groups were evaluated radiographically before surgery, immediately postoperatively, and 6, 12, 24, and 36 months postoperatively. The density of the area was measured with a digital densitometer. RESULTS: The density in group A was significantly (P < .05 to .01) greater than in group B at 6 and 12 months postoperatively. The difference at 24 months was not significant. Group A reached density levels at 6 months that were reached by group B at 12 months. CONCLUSION: The findings demonstrate that decalcified freeze-dried bone allograft enhances bone healing in jaw defects after cyst removal.

Adolescent↗
PubMed1999

Effect of formulation on the systemic absorption of insulin from enhancer-free ocular devices.

Several Gelfoam (absorbable gelatin sponge, USP) based surfactant free devices containing either sodium or zinc insulin were prepared with diluted acetic or hydrochloric acid. They were evaluated by the lowering of the blood glucose concentration in rabbits. The systemic absorption of insulin from the device can be enhanced by using a 5% or higher concentration of acetic acid solution as well as 1% HCl solution. The results indicate that the proposed device prepared with up to 30% of acetic acid solution produced no eye irritation. A single device containing 0.2 mg of insulin is sufficient to control the blood glucose levels in a uniform manner (60% of initial) for over 8 h.

Absorption↗
PubMed1997

Effect of Brij-78 on systemic delivery of insulin from an ocular device.

An ocular insert is developed for the controlled systemic delivery of insulin. Commercially available Gelfoam absorbable gelatin sponge, USP, is used in the fabrication of the ocular insert in the form of a matrix system. Two eyedrop formulations and 13 eye device formulations were evaluated. The efficacy of insulin ocular delivery was quantitated by monitoring the changes in its pharmacological response (i.e., blood glucose lowering). The in vivo results from devices containing 0.5 or 1.0 mg of insulin with 20 micrograms of polyoxyethylene-20-stearyl ether (Brij-78) give a substantial improvement in insulin activity and a significant prolongation in its duration compared with the eyedrops. In addition, the mean blood glucose concentration returns to nearly normal levels within 60 min after the removal of the device. Overall, the application of the Gelfoam device makes it feasible to obtain a prolonged systemic delivery of insulin within the desired therapeutic levels without the risk of hypoglycemia.

Animals↗
PubMed1997

Systemic delivery of insulin via an enhancer-free ocular device.

Sodium insulin and zinc insulin ocular devices are developed for the systemic delivery of insulin. The devices consist of Gelfoam (absorbable gelatin sponge, USP) as an insulin carrier and do not contain any surfactant or absorption enhancer. Sodium insulin was dissolved in either distilled water, 30% ethanol, or 10% acetic acid for either eyedrop or device preparations. Because of its low solubility in water and aqueous ethanol solution, zinc insulin was dissolved in 10% acetic acid-water solution for eye devices preparation. Commercially available Humulin R was selected as another source of zinc insulin and was used as an eyedrop as well as one device preparation. Only 10% acetic acid solution-treated insulin devices produce significant blood glucose reduction. The dose of insulin used in this study is < 50% of that used in the reported insulin devices.

Animals↗
PubMed1980

Collagen fibers as a fleece hemostatic agent.

The hemostatic efficacy of collagen fibers as a fleece hemostatic agent (CFH) is compared with the efficacy of three commercially available agents: collagen powder (Avitene), absorbable gelatin sponge, and oxidized cellulose. Identical quantities of the four materials were applied to identical multiple spleen incisions in five dogs; CFH and collagen powder proved three times as effective as the other two mateials. CFH and collagen powder were then compared with regard to hemostatic efficacy, handling characteristics, and tissue reaction. Different weights of the materials were applied to multiple spleen lacerations in 12 dogs and spleen avulsions in 12 dogs. The hemostatic efficacy of the materials was similar, but CFH was superior with regard to handling characteristics and tissue reaction. Another experiment, with six pigs, showed that CFH can be successfully sutured as a patch to profusely bleeding lacerations of the spleen, liver, and kidney.

Animals↗
PubMed1998

Hearing results of intratympanic steroid treatment of endolymphatic hydrops.

OBJECTIVES/HYPOTHESIS: This study evaluated the effectiveness of a single application of steroids to the open middle ear in improving short-term hearing in patients with Meniere's disease and cochlear hydrops. STUDY DESIGN: Retrospective study in which each patient's pretreatment hearing served as the control compared with posttreatment hearing. METHODS: Patients were treated with a single application of dexamethasone, 8 mg, in hyaluronan. Following tympanotomy and lysis of round window adhesions, steroids were placed in the round window niche with absorbable gelatin sponge and the remainder of the middle ear was then filled with the steroid solution. Systemic steroids were not administered. Audiograms were performed within 1 month before surgery and at least 1 month after surgery. RESULTS: Between September 1996 and July 1997, 21 ears in 19 patients underwent intratympanic steroid treatment. The criterion for hearing change was a 10-dB or greater change in pure-tone average (PTA), or a 15% change in speech discrimination score (SDS). Of the 15 ears meeting inclusion criteria for this study, five (33%) demonstrated hearing improvement and three (20%) demonstrated hearing deterioration. Maximum improvement was a 38-dB improvement in PTA and a 32% improvement in SDS. CONCLUSION: A single application of intratympanic dexamethasone/hyaluronan solution directly to the round window did not produce dramatic short-term hearing improvement in patients with endolymphatic hydrops. Although the theoretical basis for intratympanic steroid treatment of endolymphatic hydrops is appealing, we urge close evaluation of the results of specific protocols of intratympanic steroid administration before widespread utilization of this treatment. The choice of steroid, route of administration, frequency of application, and need for simultaneous systemic administration require standardization to adequately assess the efficacy of this treatment.

Adjuvants, Immunologic↗
PubMed1996

Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization.

PURPOSE: To elucidate major complications and their predisposing factors in transcatheter oily chemoembolization (TOCE) for hepatic tumors. MATERIALS AND METHODS: In a retrospective study of 351 patients (aged 26-82 years) with hepatic tumors, TOCE was performed 942 times with an emulsion of iodized oil (3-40 mL) and doxorubicin hydrochloride (20-60 mg). In 126 patients, TOCE was followed by absorbable gelatin sponge embolization. RESULTS: Complications were severe postembolization syndrome (n = 53); hepatic insufficiency (n = 20), infarction (n = 1), or abscess (n = 1); intrahepatic biloma formation (n = 3); tumor rupture (n = 3); septicemia (n = 9); coagulopathy (n = 1); gastrointestinal bleeding (n = 10); gallbladder (n = 5) or splenic infarction (n = 4); pulmonary oil embolism (n = 6); and spinal cord injury (n = 1). Important predisposing factors were major portal vein obstruction, compromised hepatic functional reserve, biliary obstruction, previous biliary surgery, excessive amount (> 20 mL) of iodized oil, hepatic arterial occlusion after repeated TOCE, and nonselective embolization. CONCLUSION: Most patients with major complications after TOCE had preexisting risk factors.

Adult↗
PubMed1996

Embolization of pulmonary catheter-induced pulmonary artery pseudoaneurysms.

STUDY OBJECTIVES: To determine the outcome of patients with pulmonary catheter-induced pulmonary artery pseudoansurysms (PSAs) treated with embolization. DESIGN: Retrospective outcomes review. SETTING: Large urban tertiary-care hospital. PATIENTS: All patients who presented to diagnostic angiography for ruptured pulmonary artery PSA caused by pulmonary artery catheters (PACs) from November 1990 to September 1995. A total of six patients were examined. INTERVENTIONS: Transcatheter embolotherapy with coils, absorbable gelatin sponges (Gelfoam), and suture material. RESULTS: These procedures were technically successful in all patients, and none had recurrent hemoptysis. Four of the six patients were discharged from the hospital. CONCLUSION: Embolotherapy is a useful alternative to surgery for some patients with PAC-induced pulmonary PSA.

Aged↗
PubMed2000

Uterine artery embolization in the primary treatment of uterine leiomyomas: technical features and prospective follow-up with clinical and sonographic examinations in 58 patients.

OBJECTIVE: The purpose of this study was to analyze the technical features of uterine artery embolization and to evaluate the effectiveness of this method as the primary treatment of uterine leiomyomas in a series of 58 patients monitored by clinical and sonographic examinations. SUBJECTS AND METHODS: Fifty-eight women (age range, 33-65 years; mean age, 44.5 years) with symptoms caused by uterine leiomyomas (abnormal bleeding, bulk-related symptoms, pelvic pain) were included in this prospective study. We performed embolization with a single catheter using the single-femoral artery approach, injection of particles (150-250 mm), and an absorbable gelatin sponge. Postprocedural pain was assessed using a visual analog scale. Systematic follow-up included clinical and sonographic examinations at 3 months for 58 patients, at 6 months for 46 patients, at 1 year for 27 patients, and at 2 years for seven patients. RESULTS: Embolization was performed without problems in 84% of the patients. Post-procedural pain control was excellent in 90% of the patients. In most patients, symptoms were improved or had resolved at 3 months (90%), 6 months (92%), and 1 year (93%), and all patients were symptom-free at 2 years. Clinical failure of treatment occurred in only two patients (3%). Progressive reduction in leiomyoma size was revealed during sonographic follow-up, and new leiomyomas were seen in one patient at 2 years. CONCLUSION: Uterine artery embolization is an endovascular method for the treatment of uterine leiomyomas that is clinically effective in most patients and that induces a progressive reduction in the size of the largest leiomyomas.

Adult↗
PubMed1999

New method for packing the external auditory canal, middle ear space, and mastoid cavities after otologic surgery.

Since its introduction in 1945, an absorbable gelatin sponge, Gelfoam, has long been a staple used for packing in otologic surgery. The present method commonly employed at the University of Manitoba teaching hospitals requires that operating room nurses carefully prepare extremely small pieces of both compressed and noncompressed Gelfoam. These pieces are then selectively soaked in an antibiotic solution and carefully placed, one by one, into the appropriate position. We describe a new paste preparation of Gelfoam powder, Thrombostat, acetic acid, and Bacitracin ointment, which can very quickly be injected from a syringe into the operated cavity. Our preliminary study indicates that this preparation reduces operating time, while making the process of packing easier for the surgeon. In addition, it ensures a more evenly packed cavity while still fulfilling the requirements of middle ear packing. Postoperatively, it was found to be easier to debride from the operative cavity in the office, decreasing patient discomfort and procedure time. Reported below is a preliminary clinical patient series report comparing this new method to the old method.

Acetic Acid↗