To more effectively manage the substantial
bleeding encountered during
surgical procedures in oto-rhino-laryngology, we developed a novel
hemostatic sponge made of
pharmaceutical grade, chemically cross-linked
gelatin. The sponge is characterized by a high pore density, reduced ligaments, and a high nanoscale roughness of lamella surfaces in the matrix. In vitro blood uptake assays revealed a very rapid absorption of human blood, which was two to three times faster than that measured with comparative hemostyptic devices. In an in vitro
hemorrhage model using human veins, the novel
gelatin sponge matrix induced hemostasis less than a minute after
bleeding was induced. The sponge was shown to bring about rapid hemostasis when it was administered in a young patient suffering from acute
bleeding of a pharyngeal
angiofibroma, even though the patient had been treated with an
anticoagulant because of a
transient ischemic attack. As the
gelatin matrix of the sponge is biocompatible and resorbable, the hemostyptic device could be left in place and was shown to be resorbed within 2 weeks. We hypothesize that the excellent
hemostatic performance of the sponge might be linked to enhanced capillary effects in conjunction with optimized anchoring of
fibrinogen on the nano-rough material surface, as suggested by scanning electron microscopy. The novel
gelatin sponge appears to be a promising
hemostatic matrix, which could be of great benefit for patients suffering from
epistaxis and other acute
injuries resulting in severe
bleeding.