Efficacy of Different Hemostatic Devices for Severe Liver Bleeding: A Randomized Controlled Animal Study

Background. Correct hemostasis in liver surgery is hard to achieve because of the oozing bleeding. The aim of this study was to compare the potential benefits of a new compress to the 2 commercial hemostatic compresses. Methods. Collagen- and cellulose-based hemostatics were investigated. A standardized resection was treated by applying different hemostatics in a randomized order, and bleeding times were measured. Macroscopic evaluation of the liver and tissue sampling for histological investigations were carried out after 21 days. Results . The bleeding times of bovine collagen (BoCo), protein-coated equine collagen (PECo), and oxidized cellulose (OxCe) were 140 ± 88, 243 ± 140 (P = .005 vs BoCo), and 352 ± 70 s (P < .001 vs BoCo), respectively. Microscopic evaluation of the PECo presented fibrosis and significant inflammation in the implantation zone, whereas BoCo and OxCe caused only fibrosis in the wound area. Conclusion. BoCo showed significantly better hemostatic effect than PECo and OxCe.