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Effective Control of Hepatic Bleeding With a Novel Collagen-Based Composite Combined With Autologous Plasma—Invited Critique
Harry B. Kram, MD
Torrance, Calif
Arch Surg. 2000;135:1205.
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The authors of this article should be congratulated on completing a long-overdue randomized trial evaluating the effectiveness of a combined collagen and fibrin mixture in establishing hemostasis of hepatic bleeding. Previously, other investigators reported the effectiveness of collagen and fibrin glue in controlling hepatic hemorrhage in humans,1 and a controlled experimental comparison of fibrin glue and oxidized cellulose (Surgicel; Johnson & Johnson, New Brunswick, NJ) has been accomplished in an animal model.2 However, a prospective randomized trial comparing fibrin glue mixtures with conventional hemostatic agents in humans has been demanded by scientific purists for some time. Unfortunately, this study falls short of the mark in several respects.
The present prospective trial included patients who underwent hemihepatectomy or segmental resection and were randomly assigned to treatment with either CoStasis Surgical Hemostat (a collagen-based composite combined with autologous plasma) or collagen sponge applied with pressure. Thirty-eight patients received . . . [Full Text of this Article]
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Arch Surg. 2000;135(10):1200-1204.
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