NEW METHODOLOGIES Comparison of Two Gelatin and Thrombin Combination Hemostats in a Porcine Liver Abrasion Model

Background: Surgical hemostasis is achieved using adjunctive hemostats when conventional methods fail. Objective: This study compares the effectiveness of two adjunctive gelatin-thrombin hemostats. Hypothesis: To determine effectiveness, hemostats were compared in vivo, in vitro, and using scanning electron microscopy (SEM). Methods: In vivo, a heparinized porcine liver abrasion model was used to compare hemostatic success, degree of bleeding, and blood loss at 2, 5, and 10 minutes post-treatment. In vitro, thrombin in the supernatant of each hemostat and Red Blood Cells (RBC’S) in the supernatant of clots formed by each was compared. Results: Ultrastructure of one gelatin was smooth and the other stellate. In vivo, smooth gelatin provided superior hemo-static success at 5 (85 % vs. 60%; OR: 5.3; 95%CI: 1.66 to 17.9) and 10mins (72.5 % vs. 47.5%; OR: 5.0; 95%CI: 1.55 to 16.1). Smooth gelatin had a statistically different degree of bleeding at 5 (0.58 ± 0.87 [Mean ± SD] vs. 1.03 ± 1.12