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Results for “Gelatin Sponge, Absorbable”

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At least 91 records · Page 5Linked to original sources

PubMed1976

Poststapedectomy otitis media and meningitis.

A patient developed acute otitis media, labyrinthitis, and meningitis 16 months after a stapedectomy operation, and 14 similar cases have been collected from the literature. Poststapedectomy otitis media carries an increased risk of labyrinthitis and meningitis and requires prompt antibiotic therapy and regular observation until cured. Should labyrinthitis occur, with or without meningitis, fistula repair must be undertaken as soon as the infection is eliminated. All stapedectomy patients require regular supervision, and must report for urgent treatment if symptoms of otitis media or perilymph fistula occur. Stapedectomy techniques should not employ sharp bevelled prostheses, and autogenous tissue grafts are probably superior to an absorbable gelatin sponge in protecting the inner ear. Eustachian tube problems and recurring or chronic upper-respiratory tract infections can predispose to middle ear infection and are thus contraindications to stapedectomy.

Adult↗

PubMed1985

Posttraumatic pseudoaneurysm of the extracranial middle meningeal artery.

Pseudoaneurysms of the extracranial arterial tree are uncommon. To our knowledge, four cases of pseudoaneurysm of the internal maxillary artery have been reported, but there have been no reports of pseudoaneurysm of the extracranial segment of the middle meningeal artery. A 15-year-old girl, who suffered a gunshot wound in the right maxillary region, suffered a pseudoaneurysm of the proximal portion of the middle meningeal artery, as shown by carotid angiography six days after injury. The lesion was successfully treated with absorbable gelatin sponge embolization. Treatment of pseudoaneurysms reduces the risk of hemorrhage from subsequent rupture. Although these lesions are amenable to surgery, transvascular embolization or mechanical interruption appears to be simpler and equally effective.

Adolescent↗

PubMed1984

Massive hematuria following percutaneous biopsy of renal allograft. Successful control by selective embolization.

We report on a patient who underwent a percutaneous needle biopsy of a renal allograft for evaluation of compromised function. Gross hematuria occurred immediately and persisted for three weeks, interrupted only by long intervals of anuria due to obstruction by a clot. The bleeding was controlled successfully by selective transcatheter embolization with a coli and an absorbable gelatin sponge (Gelfoam). The techniques and complications of allograft biopsy procedures are reviewed, and the management of hematuria occurring after a percutaneous needle biopsy is discussed. A percutaneous needle biopsy is the preferred method of sampling the transplanted kidney, with an adequate specimen obtained in 96% of cases. Hematuria, that has been reported to complicate 7% of percutaneous biopsy procedures, is usually transient, and only rarely is intervention required. Angiographically directed selective embolization is an effective technique for controlling massive or prolonged urinary hemorrhage after renal allograft biopsy.

Adolescent↗

PubMed1993

Experience with liver resection after hepatic arterial chemoembolization for hepatocellular carcinoma.

The use of percutaneous transcatheter hepatic arterial chemotherapy and embolization in the treatment of primary liver cancer has become increasingly popular in recent years. The authors employed this method, using a combination of cisplatin, mitomycin C, 5-fluorouracil, and ethiodized oil (Lipiodol) or absorbable gelatin sponge in 30 patients with huge liver cancers (diameter range, 5.6-12.0 cm) as a preliminary treatment before liver resection. Significant tumor regression occurred after this treatment, converting these tumors into resectable lesions that were excised successfully later. Before surgery, chemoembolization was done once every 4-6 weeks. The patients underwent 1-5 treatment sessions (mean, 2.9) and then waited 1-4 months (mean, 2.4 months) before undergoing surgery. Alpha-fetoprotein levels decreased to normal in seven patients. The tumor diameters were reduced by 31.6 +/- 15.2% (2.3 +/- 1.2 cm) and the percent tumor necrotic area ranged from 40-100%. Adhesions of the tumor to the diaphragm and thickening of the hepatoduodenal ligament and gallbladder wall were the primary operative findings, but they did not significantly complicate the surgery. There was one postoperative death from acute pulmonary embolism. The 1-year, 2-year, and 3-year survival rates were 88.89%, 77.03%, and 77.03%, respectively. Although these patients still are being followed to assess their long-term survival, this treatment appears promising for patients with advanced huge liver cancers who hitherto have been denied surgery on grounds of unresectability.

Adult↗

PubMed1989

Brain biocompatibility of a biodegradable, controlled-release polymer in rats.

We report the biocompatibility in the rat brain of a controlled-release, biodegradable polymer, the polyanhydride poly-[bis(p-carboxyphenoxy)propane-sebacic acid] copolymer (PCPP-SA) in a 20:80 formulation. The biodegradable polyanhydride can be used for drug delivery directly into the brain, circumventing the difficulties posed by the blood-brain barrier and avoiding the consequences of having to administer toxic doses systematically to reach therapeutic doses in the central nervous system. The tissue reaction in the presence of PCPP-SA was compared to that seen with other standard neurosurgical implants. Fifty-six adult Sprague-Dawley rats were assigned to one of seven groups and underwent bilateral frontal lobe implantation of PCPP-SA (42 hemispheres), Surgicel (oxidized regenerated cellulose) (35 hemispheres), or Gelfoam (absorbable gelatin sponge) (35 hemispheres). None of the animals showed any behavioral changes or neurological deficits suggestive of either systemic or localized toxicity from the biodegradable polyanhydride, all surviving to the scheduled data of sacrifice. PCPP-SA evoked a well localized inflammatory reaction, comparable to that of Surgicel, which resolved as the PCPP-SA polymer degraded over five weeks. The biodegradable polyanhydride has been shown in this study to be nontoxic and biocompatible in the rat brain, when compared to standard neurosurgical implants.

Animals↗

PubMed1995

Contaminated fractures of the tibia: a comparison of treatment modalities in an animal model.

External fixation is the current standard treatment for skeletal stabilization of open tibial fractures, but intramedullary fixation techniques have become increasingly popular. The aim of this study was to compare, in an animal model, the susceptibility to infection of contaminated fractures stabilized with external fixation with that of contaminated fractures fixed with intramedullary locking nails with or without reaming. A unilateral osteotomy of the tibia was performed in 15 goats under general anesthesia. Each osteotomy was stabilized with either (a) a unilateral biplanar external fixator, (b) an 8 mm diameter intramedullary rod inserted without reaming of the medullary cavity, or (c) a 10 mm diameter rod inserted after reaming. A standardized inoculum of Staphylococcus aureus, 10(3) colony forming units per milliliter, was placed at each osteotomy site on a piece of absorbable gelatin sponge, to simulate contamination of an open fracture. Antibiotics were not administered. The animals were allowed full activity after the procedure. Fourteen days postoperatively, the animals were killed, radiographs of the tibiae were taken, and the tibiae were harvested in a sterile manner. Multiple specimens for quantitative microbiological analysis were taken from the fracture site and from sites 3 cm distal and 6 cm proximal to the fracture. Additional specimens of bone were taken for histological study. Clinical, radiographic, and microbiological analysis demonstrated that, in this animal model, there were significantly fewer and less severe infections in fractures fixed with external fixation than in those fixed with an intramedullary nail with or without reaming. There was marked cortical necrosis in tibiae that had been fixed with nailing and reaming.

Animals↗

PubMed2004

Intraoperative packing of a pancreatic pseudocyst complicated with bleeding pseudoaneurysm.

Hemosuccus pancreaticus (HP) is a rare cause of gastrointestinal bleeding, usually due to rupture of a visceral artery aneurysm in chronic pancreatitis. Other causes of HP are rare. We present a case of HP which occurred in a patient with chronic calcifying pancreatitis and a pancreatic pseudocyst documented by ultrasonography and computed tomography. With detectable fresh blood in the descending duodenum, an aneurysm in the pancreatic head was revealed by superior mesenteric angiography as the suspected origin of intermittent bleeding from the pancreatic duct. Because an artery feeding the pseudocyst could not be identified, angiographic embolization was not possible. Surgical resection or ligation was difficult by laparotomy; therefore, intraoperative packing of the pseudocyst with absorbable gelatin sponges was achieved via a cannula through a directly punctured site in the pseudocyst wall. The patient has been followed for 4.25 years with no further episodes of HP. It is possible that the packing of a pancreatic pseudocyst with gelatin sponges is a method that can be used in similar cases, where control of hemostasis is the primary concern. The packing of a pancreatic pseudocyst with gelatin sponges is a technique that can be performed not only via laparotomy but also via laparoscopy or concomitant angiography and ultrasonography.

Aneurysm, False↗

PubMed2002

Spontaneous liver hematoma and a hepatic rupture in HELLP syndrome: report of two cases.

Subcapsular liver hematomas and ruptures are unusual fatal complications of HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome (HS). We present two cases of a spontaneous rupture of subcapsular liver hematoma occurring in HS and review the literature on this subjects. One case demonstrated a secondary rupture of a subcapsulary liver hematoma due to HS in one patient and HS associated with preeclampsia in another. The defects were on the medial and lateral sectors of the left lobe in one patient and on the medial sector of the right lobe in the other patient. In case 1 deep mattress sutures and omentoplasty were performed, and in the other case a defective area was closed with an absorbable gelatin sponge with a hemostatic effect. In addition, the liver was compressed by abdominal towels. A high index of suspicion and immediate recognition are keys to proper diagnosis and management of affected patients. The multidisciplinary approach to the management of these patients led to a remarkable decrease in the mortality rates. Less aggressive treatment is preferable to aggressive intervention such as a hepatic resection in such patients with coagulopathy.

Adult↗

PubMed1981

The effects on extraction wound healing of a new drug combination introduced for use in the prevention of post-extraction complications. A preliminary report.

Fifteen extraction sockets packed with a new drug combination which includes a local anaesthetic (cincain chloride), a local antiseptic (tri-iodomethane) and two drugs with a potent antifibrinolytic activity (tranexamic acid and propyl-hydroxy-benzoic acid) in an absorbable gelatin sponge (Gelfoam) as a vehicle, were histologically assessed with special reference to the parameters related to wound healing. As a control, the same number of sockets were allowed to heal spontaneously and similarly assessed. Healing of the extraction wounds seemed to follow the normal sequence in both series, and no histological signs suggestive of a delay in the healing process could be found in any of the sockets studied. Also the mast cell count previously considered to be of importance in the connective tissue repair was found to be unaffected by the test substance. These results, together with the previously presented data on the clinical efficacy of the drug combination studied, suggest that a larger clinical study should be carried out to assess its value as a preventive measure against the development of the post-extraction symptoms, including dry socket.

Adolescent↗

PubMed1999

Cerebrospinal fluid leakage during endscopic forehead lifting.

PURPOSE: To report a case of endoscopic brow lift in which cerebrospinal fluid leakage was encountered. METHOD: A 69-year-old otherwise healthy man underwent endoscopic forehead lifting. RESULTS: An area of strong adherence was encountered in the area of the left superior paracentral scalp incision. As the adherence was released, clear fluid extruded (cerebrospinal fluid) and a burr hole was discovered. Absorbable gelatin sponge was placed over the dural defect and burr hole, and closure of the endoscopic scalp incisions was accomplished. CONCLUSION: Caution is suggested in performing this procedure when a patient has any history of a head trauma.

Aged↗

PubMed1994

Correction of deteriorating renal function by superselective embolization of an arcuate renal artery pseudoaneurysm.

We performed superselective embolization of an iatrogenic pseudoaneurysm of the right kidney that was causing hematuria and deterioration of renal function in a patient with chronic renal failure. An arcuate artery was embolized with absorbable gelatin sponge and a straight embolization wire without significant loss of renal vascularization, thus restoring baseline renal function. To our knowledge the clinical and technical aspects of our case are unique. The technique is described.

Aged↗

PubMed1991

Use of methylene blue and selective embolization of the pudendal artery for high flow priapism refractory to medical and surgical treatments.

High flow priapism is often treated effectively with intracavernous vasoconstrictive agents or surgical shunting. If these maneuvers fail treatment is unclear. A 21-year-old black man, who had failed previous pharmacological and surgical therapies, temporarily (8 hours) responded to intracavernous methylene blue, which is known to antagonize endothelial derived relaxation factor. Recurrent priapism was managed successfully by embolization of the left internal pudendal artery with absorbable gelatin sponge. Review of the literature reveals that only 7 patients have been managed with arterial embolization and our case represents the first in which intracavernous methylene blue produced detumescence.

Adult↗

PubMed1984

Renal cell carcinoma--angioinfarction.

In our experience the mortality rate in 46 patients who underwent angioinfarction for renal cell carcinoma was 4 per cent. Fever, ileus and leukocytosis were noted in 86 to 90 per cent of our patients. The use of absolute ethanol as a medium for renal infarction was associated with a significant incidence of damage to other organs. A 30 per cent decrease in tumor volume following angioinfarction using absorbable gelatin sponge and Gianturco coils was noted in 75 per cent of the patients. There was no evidence of metastatic tumor reduction and we could not document any significant decrease in operative time or blood loss. It would appear that there is some increased survival rate in patients with metastasis who are given adjuvant immune ribonucleic acid therapy. However, the numbers in our series are not significant to draw any definite conclusion. It is apparent that patients treated with infarction, delayed nephrectomy and medroxyprogesterone acetate did not have any significant survival over those treated with palliative nephrectomy or chemotherapy. The macrophage maturation assay may be useful during clinical followup.

Adenocarcinoma↗

PubMed1983

Therapeutic embolization of the kidney with detachable silicone balloons.

Detachable silicone balloons were used for therapeutic renal artery embolization in 14 patients. Hematuria was controlled by occlusion of the arteriovenous fistulas in 6 patients and aneurysms in 3. The method was used for preoperative occlusion of the renal artery in 4 patients with renal cell carcinoma and for renal ablation in an attempt to cure hypertension in 1 additional patient. Detachable silicone balloons offer a safe and precise method for the occlusion of traumatic arteriovenous fistulas and aneurysms of the renal artery branches. Although balloon embolization also can be applied to the preoperative occlusion of renal neoplasms the conventional embolization techniques using absorbable gelatin sponge and coils are equally effective with less expense. No complications were observed in our 14 patients.

Adenocarcinoma↗

PubMed2003

Fibrin-glue sealed liver biopsy in patients with a liver transplantation or in liver transplantation waiting list: preliminary results.

Liver biopsy is frequently necessary for candidate evaluation or histologic follow-up of transplanted livers. Although generally considered to be safe, it carries a risk of complications in up to 0.5% of cases; hemorrhage being the most important. It can present as an asymptomatic intra- or perihepatic hematoma or result in overt hemorrhage of variable intensity. Patients with deranged hemostasis or on antiaggregant therapy are at high-risk for hemorrhagic complications. Percutaneous liver biopsy may be contraindicated if hemostasis is profoundly disordered. Safety values are not well defined: arbitrary limits are 60% prothrombin activity and 60,000 platelets per mm3. Patients with more altered values are candidates for alternative techniques, such as transjugular biopsy. Another option is the so-called plugged percutaneous liver biopsy, which uses direct injection of a plugging material into the biopsy tract. Different materials have been used: Tissucol, absorbable gelatin sponge, or hemostasis coils. We communicate our experience with Tissucol (fibrin glue) plugging in 30 percutaneous liver biopsies on 16 patients after liver transplantation with prothrombin activity <60%, platelet count <60,000 per mm3, or both. Only two complications were observed. Plugged liver biopsy is an efficient and relatively safe procedure in patients with impaired hemostasis; it can be performed even when transjugular biopsy is not available.

Biopsy↗

PubMed1976

Treatment of hypersplenism by embolus placement in the splenic artery.

In a patient with liver cirrhosis and severe hypersplenism resistent to corticosteroids splenectomy was attempted but proved impossible. Embolisation of the splenic artery with tiny fragments of absorbable gelatin sponge induced gradual restitution of haematological function to normal after 6 wk. Abdominal pain, paralytic ileus of short duration, transient pyrexia, and pleural effusion ensued but were well tolerated. The patient has remained well, 2 1/2 mo later. It is suggested that this simple method may prove rewarding and could safely be used, if necessary, more than once in patients for whom other treatments are unsuitable or have failed.

Angiography↗

PubMed1998

Pelvic congestion syndrome: early clinical results after transcatheter ovarian vein embolization.

PURPOSE: This case series describes the early radiographic and clinical results of attempted transcatheter ovarian vein (OV) embolization in 11 women with symptoms that were suggestive of the pelvic congestion syndrome (PCS). METHODS: Eleven women (mean age, 33.1 years) who were multiparous were referred for lower extremity or vulvar varicosities (n = 8) or for tubo-ovarian varicosities (n = 3). After a clinical diagnosis of PCS was established, the women underwent ovarian (n = 5) or ovarian and iliac vein (n = 6) venography. Enlarged or incompetent OVs were embolized with 0.035-inch stainless steel coils or with 0.018-inch platinum microcoils and absorbable gelatin sponge. Incompetent tributaries to hypogastric veins were embolized as well (n = 1). Symptoms before embolization and after embolization were recorded with a standard questionnaire, and the post-embolization symptoms were expressed as individual and overall percent relief. RESULTS: Nine of the 11 women underwent embolization. Embolization of both OVs (n = 4), of the left OV alone (n = 4), or of a left obturator vein that communicated with vulvar varices (n = 1) was performed. Eight of the 9 women (88.9%) had more than 80% immediate relief. Overall and individual symptom relief varied from 40% to 100% at the mean 13.4-month follow-up. One woman with variant anatomy and one woman with evidence of prior left OV thrombosis were not treated. There were no major complications. Two women had a mild to moderate return of the symptoms at 6 and 22 months. CONCLUSIONS: Transcatheter embolization provides excellent initial and variable midterm relief in women with typical PCS symptoms and with OV or OV and internal iliac (hypogastric) tributary vein incompetence. This interventional technique may replace or complement the traditional surgical approaches to this rarely recognized and poorly understood disease.

Adult↗

PubMed1993

Controlled delivery of pilocarpine. 1. In vitro characterization of Gelfoam matrices.

The potential of Gelfoam absorbable gelatin sponge as a carrier for ophthalmic delivery of pilocarpine was examined. Prolonged in vitro release of pilocarpine was achieved through pharmaceutical modification of the device by embedding a retardant in the pores. The device embedded with cetyl ester wax released pilocarpine in a zero-order pattern (release exponent = 0.93 +/- 0.04) for up to 5 hr. This result corresponded well with a linear penetrant uptake by this device. The device impregnated with polyethylene glycol 400 monostearate exhibited anomalous drug transport with a release exponent of 0.63 +/- 0.02. The absorption of water by this retardant and the formation of a gel layer on the surface slowed the penetration of the release medium into the deeper sections of the matrix, as well as the rapid outward diffusion of drug, resulting in a prolonged release of pilocarpine.

Chromatography, High Pressure Liquid↗