TY - JOUR
T1 - Efficacy of New Polylactic Acid Nonwoven Fabric as a Hemostatic Agent in a Rat Liver Resection Model
AU - Wakabayashi, Taiga
AU - Yagi, Hiroshi
AU - Tajima, Kazuki
AU - Kuroda, Kohei
AU - Shinoda, Masahiro
AU - Kitago, Minoru
AU - Abe, Yuta
AU - Oshima, Go
AU - Hirukawa, Kazuya
AU - Itano, Osamu
AU - Kitagawa, Yuko
N1 - Funding Information:
The authors are grateful to Ms Naho Murakawa and Ms Rie Kinoshita from the Department of Surgery, and Dr Toshihiro Nagai from the Electron Microscope Laboratory, Keio University School of Medicine, for their aid during the experimental surgery in the animal study. The authors are also grateful to Mr Guy Temporal, Mr Christopher Burel, and Ms Iana Shutrova for proofreading the text as well as to Ms. Catherine Cers for her digital illustrations, which serve as schematics in the present article. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Dr Taiga Wakabayashi, Dr Hiroshi Yagi, Dr Kazuki Tajima, Dr Kohei Kuroda, Dr Masahiro Shinoda, Dr Minoru Kitago, Dr Yuta Abe, Dr Go Oshima, Dr Kazuya Hirukawa, Dr Osamu Itano, and Prof Yuko Kitagawa received a research fund from the Toray Industries Inc (Tokyo, Japan) for conducting the study.
Publisher Copyright:
© The Author(s) 2019.
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Background. During minimally invasive surgery, efficient and nontoxic hemostats are important for difficult to access bleeding areas. Polylactic acid is an ecofriendly hemostatic agent and we aimed to evaluate the efficacy of a polylactic acid nonwoven fabric (PLAF) developed by Toray Industries, Inc, on liver hemostasis in a preclinical study. Materials and Methods. PLAF consists of both 1-µm diameter fibers and 100-µm diameter beaded fibers. Four rats were used, and 2 trough-shaped resections of the liver parenchyma were performed (n = 8 lobes). Immediately after the resection, PLAF (PLAF group: n = 4 lobes) or rayon gauze (Rayon group: n = 4 lobes) were applied on the resected plane and compressed manually. We compared the mean time to hemostasis and blood loss per lobe, as well as histological findings between the groups. Results. The PLAF group had a significantly shorter bleeding time (P =.006), and showed lower blood loss compared with the Rayon group (P =.076). Histopathological evaluation showed a large amount of beads on the liver surface in the PLAF group. Aggregated red blood cells evident by electron microscopy and von Willebrand factor immunofluorescence were seen surrounding the beads. The PLAF group showed significantly greater von Willebrand factor expression than the Rayon group (P =.004). Discussion. This new PLAF showed superior outcomes thanks to its unique characteristic of forming beaded nanofibers, and it has the potential to be an efficient hemostat in minimally invasive surgery in the human body.
AB - Background. During minimally invasive surgery, efficient and nontoxic hemostats are important for difficult to access bleeding areas. Polylactic acid is an ecofriendly hemostatic agent and we aimed to evaluate the efficacy of a polylactic acid nonwoven fabric (PLAF) developed by Toray Industries, Inc, on liver hemostasis in a preclinical study. Materials and Methods. PLAF consists of both 1-µm diameter fibers and 100-µm diameter beaded fibers. Four rats were used, and 2 trough-shaped resections of the liver parenchyma were performed (n = 8 lobes). Immediately after the resection, PLAF (PLAF group: n = 4 lobes) or rayon gauze (Rayon group: n = 4 lobes) were applied on the resected plane and compressed manually. We compared the mean time to hemostasis and blood loss per lobe, as well as histological findings between the groups. Results. The PLAF group had a significantly shorter bleeding time (P =.006), and showed lower blood loss compared with the Rayon group (P =.076). Histopathological evaluation showed a large amount of beads on the liver surface in the PLAF group. Aggregated red blood cells evident by electron microscopy and von Willebrand factor immunofluorescence were seen surrounding the beads. The PLAF group showed significantly greater von Willebrand factor expression than the Rayon group (P =.004). Discussion. This new PLAF showed superior outcomes thanks to its unique characteristic of forming beaded nanofibers, and it has the potential to be an efficient hemostat in minimally invasive surgery in the human body.
KW - biomedical engineering
KW - evidence-based medicine/surgery
KW - hepatobiliary
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U2 - 10.1177/1553350619833582
DO - 10.1177/1553350619833582
M3 - Article
C2 - 30895890
AN - SCOPUS:85063333139
SN - 1553-3506
VL - 26
SP - 312
EP - 320
JO - Seminars in Laparoscopic Surgery
JF - Seminars in Laparoscopic Surgery
IS - 3
ER -