The effect of the new hemostatic agent Ostene on bone healing: an experimental study in rabbits

Introduction: Ostene is a water-soluble wax-like alkylene oxide copolymer preparation for use as a mechanical hemostatic agent. this study aims to evaluate the effects of Ostene on bone healing. materials and methods: twenty albino rabbits were divided into four groups according to post-treatment follow-up (24 hr, 3 days, 7 days, 14 days) with five rabbits in each group. each rabbit in all groups was treated with two study materials (Ostene and Gelfoam). three holes were made in the mandibular bone of each rabbit using 5mm surgical bur; two holes were made on right side: one for testing Ostene and another for Gelfoam. a third hole, on the left side of mandible, was not treated, and was used as a control. finally, the incision was closed. the specimens were collected at different days post-treatment and examined by histopathology. result and discussion: this study showed that there is a significant difference (p-value≤ 0.05) between the Ostene group and the other groups (Gelfoam and control). at 24 hr post intervention, there is a significant difference in osteoblast cell formation (p-value=0.03), and osteoclast cell formation (p-value=0.05). new blood vessel formation, osteoblast and osteoclast cell formation for Ostene group at 3 days post-intervention were also significantly different (p-values = 0.05, 0.03, 0.04, respectively). at 7 days post-intervention p-values were 0.05 for osteoblast formation and 0.04 for osteoclast formation, respectively. after 14 days of healing p-value for osteoblast cell formation in the Ostene group was 0.05 and 0.04 for osteoclast cell formation. conclusions: the bone hemostatic agent Ostene is an effective at enhancing osteogenesis by initiating proliferation of osteoblast and osteoclast cells.

Bleeding time using Moringa oleifera (Malunggay) leaf extract versus saline control in a rabbit epistaxis model: A randomized controlled trial

OBJECTIVE: To determine bleeding time using Moringa oleifera leaf extract versus saline control in an experimental epistaxis model.METHODS:Design: Randomized controlled trialSetting: Tertiary Government Training HospitalParticipants: Ten adult male New Zealand White rabbits were acclimatized for 1 week in a standard environment. One-centimeter long, full-thickness mucosal wounds in the junction of the nasal floor and anterior part of the septum were treated randomly with topical Moringa oleifera extract or colored isotonic saline control in either right or left nasal cavity, one site at a time. The duration of bleeding - time bleeding started to time bleeding stopped -- was recorded in seconds. Data was subjected to a t-test for paired samples.RESULTS: The mean bleeding time for wounds treated with Moringa extract was 53 seconds (range 38-70 secs), versus 159 seconds (range 100-218 secs) for controls. The bleeding time in the former was significantly shorter than in the latter (p = .000019, t-stat = 8.139), with a mean difference of 106 seconds between the two groups.CONCLUSION: Moringa oleifera leaf extract was associated with significantly shorter bleeding time than saline control in this experimental epistaxis model and may be worth investigating further as a hemostatic agent for epistaxis.

Bleeding time using Moringa oleifera (Malunggay) leaf extract versus saline control in a rabbit epistaxis model: A randomized controlled trial

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To determine bleeding time using Moringa oleifera leaf extract versus saline control in an experimental epistaxis model.<br /><strong>METHODS:</strong><br /><strong>Design:</strong> Randomized controlled trial<br /><strong>Setting:</strong> Tertiary Government Training Hospital<br /><strong>Participants:</strong> Ten adult male New Zealand White rabbits were acclimatized for 1 week in a standard environment. One-centimeter long, full-thickness mucosal wounds in the junction of the nasal floor and anterior part of the septum were treated randomly with topical Moringa oleifera extract or colored isotonic saline control in either right or left nasal cavity, one site at a time. The duration of bleeding - time bleeding started to time bleeding stopped -- was recorded in seconds. Data was subjected to a t-test for paired samples.<br /><strong>RESULTS:</strong> The mean bleeding time for wounds treated with Moringa extract was 53 seconds (range 38-70 secs), versus 159 seconds (range 100-218 secs) for controls. The bleeding time in the former was significantly shorter than in the latter (p = .000019, t-stat = 8.139), with a mean difference of 106 seconds between the two groups.<br /><strong>CONCLUSION:</strong> Moringa oleifera leaf extract was associated with significantly shorter bleeding time than saline control in this experimental epistaxis model and may be worth investigating further as a hemostatic agent for epistaxis.</p>

Effect of collagen sponge and fibrin glue on bone repair

ABSTRACT The ability of hemostatic agents to promote bone repair has been investigated using in vitro and in vivo models but, up to now, the results are inconclusive. Objective In this context, the aim of this study was to compare the potential of bone repair of collagen sponge with fibrin glue in a rat calvarial defect model. Material and Methods Defects of 5 mm in diameter were created in rat calvariae and treated with either collagen sponge or fibrin glue; untreated defects were used as control. At 4 and 8 weeks, histological analysis and micro-CT-based histomorphometry were carried out and data were compared by two-way ANOVA followed by Student-Newman-Keuls test when appropriated (p≤0.05). Results Three-dimensional reconstructions showed increased bone formation in defects treated with either collagen sponge or fibrin glue compared with untreated defects, which was confirmed by the histological analysis. Morphometric parameters indicated the progression of bone formation from 4 to 8 weeks. Additionally, fibrin glue displayed slightly higher bone formation rate when compared with collagen sponge. Conclusion Our results have shown the benefits of using collagen sponge and fibrin glue to promote new bone formation in rat calvarial bone defects, the latter being discreetly more advantageous.

Efficacy of Intra-Articular Injection of Thrombin-Based Hemostatic Agent in the Control of Bleeding after Primary Total Knee Arthroplasty

PURPOSE: To evaluate the hemostatic effect of intraarticular injection of a thrombin-based hemostatic agent in total knee arthroplasty (TKA). MATERIALS AND METHODS: We performed a prospective randomized controlled trial on the use of a thrombin-based hemostatic agent in patients undergoing unilateral TKA. A total of 100 TKA patients were enrolled, with 50 patients randomized into the study group and the other 50 patients into the controlled group. Drain output, hemoglobin level, total red blood cell loss for 24 hours after surgery, transfusion rates, and complications were assessed. RESULTS: Postoperative drain output was 525 mL in the study group and 667 mL in the control group (p=0.01). Nine patients in the study group and eighteen in the control group received blood transfusion (p=0.043). But, there was no significant difference between two groups in terms of hemoglobin level change and total red blood cell loss (p>0.05). CONCLUSIONS: The thrombin-based hemostatic agent demonstrated efficacy in reducing drain output and blood transfusion rates. Thus, we believe the use of a thrombin-based hemostatic agent should be considered as an option in orthopedic surgery that involves massive bleeding.

Biologic response of local hemostatic agents used in endodontic microsurgery

Appropriate use of local hemostatic agent is one of the important factors on the prognosis of endodontic microsurgery. However, most investigations to date focus on the hemostatic efficacy of the agents, whereas their biologic characteristics have not received enough attention. The purpose of this paper was to review the biologic response of local hemostatic agents, and to provide clinical guidelines on their use during endodontic microsurgery. Electronic database (PUBMED) was screened to search related studies from 1980 to 2013, and 8 clinical studies and 18 animal studies were identified. Among the materials used in these studies, most widely-investigated and used materials, epinephrine, ferric sulfate (FS) and calcium sulfate (CS), were thoroughly discussed. Influence of these materials on local tissue and systemic condition, such as inflammatory and foreign body reaction, local ischemia, dyspigmentation, delayed or enhanced bone and soft tissue healing, and potential cardiovascular complications were assessed. Additionally, biological property of their carrier materials, cotton pellet and absorbable collagen, were also discussed. Clinicians should be aware of the biologic properties of local hemostatic agents and their carrier materials, and should pay attention to the potential complications when using them in endodontic microsurgery.

CoolClot, a novel hemostatic agent for controlling life-threatening arterial bleeding / 世界急诊医学杂志（英文）

@#BACKGROUND: Uncontrolled bleeding is the first leading cause of preventable death in the battlefield and the 2nd cause of mortality in civil accidents. Incompressible hemorrhage control is among the interventions that drastically increase the survival rate in wound individuals. We have previously shown that a certain mixture of bentonite and zeolite minerals can significantly decrease the bleeding in rats. METHODS: In this study, nine healthy hybrid dogs were selected and after induction of anesthesia with ether, either arterial puncture by a needle or arteriotomy was performed on both groin regions of the dogs. For control arteries (either the right or left femoral artery), only pressure by sterilized gauze was performed, while for the femoral arteries of the opposite side, our invented hemostatic agent, namely CoolClot, was topically used before applying the pressure. In the second stage of the study, to assess the coagulation time, blood samples were collected from 10 volunteer students. RESULTS: CoolClot significantly decreased the bleeding time in animals whose femoral arteries were cut or punctured. In the human phase of the study, the mean coagulation time in control blood samples was 253.4±44.1 seconds, whereas it was 149.5±50.0, 162.3±74.6 and 143.4±114.6 seconds, respectively in blood samples treated with bentonite, zeolite and CoolClot (P<0.05). CONCLUSIONS: As controlling bleeding after a life-threatening arterial damage is critical for increasing the chance of survival, the results obtained in this study indicate the significant efficacy of CoolClot in shortening the bleeding time. Our experiments also indicate that CoolClot can significantly reduce the clotting time in human blood samples.

The influence of hemostatic agent contamination on bond strengths on dentin bonding agents / 대한치과보철학회지

PURPOSE: This study examined the recovery of the dentin-resin bonding strength, and the difference in the bonding strength after applying pH hemostatic agents at various pH. MATERIALS AND METHODS: Bosmin, Hemodent, Astregedent, and Visine were used as the hemostatic agents in this study. The Bosmin, Hemodent, and Astrigedent hemostatic agents are acidic, and the Visine hemostatic agent is neutral and is used as a decongestant. Ninety human molar teeth were used as the specimen. The teeth were sectioned using a diamond wheel until the dentin was exposed and wet ground by silica paper. The specimens were divided into two groups according to the hemostatic agent used. The specimens were then subdivided into 9 groups according to the application of re etching (R group) or rinsing only (N group). A commonly used resin bonding procedure was used in the control group. The resin bonding procedure was managed dentin using celluloid capsule. In addition, the shear bond strength was measured using an Instron. RESULTS: In general, samples with the applied hemostatic agent, with the exception of Visine, had a slightly weak bond that was similar to the control group. In addition, the rinsing only (N) group had slightly weak bond that was similar to the re etching (R) group. CONCLUSION: The application of a hemostatic agent on the dentin surface does not affect the shear bond strength after application for a short time. In addition, rinsing only can recover the shear bond strength making other management procedures redundant, particularly re etching.