Hemostatic Efficacy and Biocompatibility Evaluation of a Novel Absorbable Porous Starch Hemostat

Surg Innov. 2022 Jun;29(3):367-377. doi: 10.1177/15533506211046100. Epub 2021 Sep 22.

Abstract

Background: A novel absorbable porous starch hemostat (APSH) based on calcium ion-exchange crosslinked porous starch microparticles (Ca2+CPSM) was developed to improve hemostasis during surgeries for irregular cuts. The aim of this study was to compare its hemostatic efficacy and biocompatibility in a standard rat liver injury model relatively to Arista AH, Quickclean, and crosslinked porous starch microparticles (CPSM, without calcium ion).

Methods: 72 Wistar rats (220g-240 g) were randomly assigned to six groups (Arista, Quickclean, CPSM, Ca2+CPSM, native potato starch, and untreated control group, n =12 per group). 30 mg of each hemostatic agent was applied to a standard circular liver excision (8 mm in diameter and 3 mm deep) in rats. Following their hemostatic efficacy, in vivo biocompatiblity evaluation was examined. The native potato starch (NPS) group was used as the negative group.

Results: Ca2+CPSM had almost the same hemostatic efficacy compared with Arista; meanwhile, all the 4 hemostatic agents had good blood compatibility. In terms of in vivo tissue compatibility, Ca2+CPSM had relatively fast degradation and absorption rate with good histocompatibility. As the morphological, anatomic observation and H&E staining of liver defects after implantation, Ca2+CPSM was almost completely absorbed by liver tissue after 14 days.

Conclusion: According to our study, Ca2+CPSM could effectively achieve hemostasis in the standard rat liver injury model and exhibited good blood compatibility and in vivo tissue compatibility. These finding suggested that Ca2+CPSM as a new kind of APSH had its extensive clinical application value.

Keywords: biodegradability; hemostasis; in vivo study; liver injury.

MeSH terms

  • Animals
  • Calcium / pharmacology
  • Hemostasis
  • Hemostatics* / pharmacology
  • Hemostatics* / therapeutic use
  • Porosity
  • Rats
  • Rats, Wistar
  • Starch / pharmacology
  • Starch / therapeutic use

Substances

  • Hemostatics
  • Starch
  • Calcium