International Surgery Journal | July-September 2016 | Vol 3 | Issue 3 Page 1551 International Surgery Journal Broekema FI et al. Int Surg J. 2016 Aug;3(3):1551-1556 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Research Article Analysis of the hemostatic efficacy of polyurethane foam using a novel method to compare topical hemostatic agents in a rat tail-tip model Ferdinand I. Broekema 1 *, Wim Van Oeveren 2,3 , Rudolf R.M. Bos 1 INTRODUCTION Many different topical hemostatic agents are used in the surgical disciplines. The most widely used agents are collagen, gelatin and oxidized regenerated cellulose (ORC). There is no consensus on which of these agents has the best hemostatic efficacy and each product has significant potential drawbacks. As a result, none of the products has become dominant over the other topical hemostatic agents. 1 A disadvantage of collagen and gelatin hemostatic agents is that they are animal derived and therefore carry the potential risk of pathogen transmission. The ORC can lead to inflammation of surrounding tissue and delay wound healing because of its low pH. 2 A recently developed fully synthetic topical hemostatic agent with a good biocompatibility could avoid these potential risks. Polyurethane (PU) is a synthetic, biodegradable material with good biocompatible properties. 3 The hemostatic capacity of this material was ABSTRACT Background: A broad variety of topical hemostatic agents are used in the surgical disciplines. We analysed the most widely used topical hemostatic agents and compared them to a recently developed, synthetic topical hemostatic agent based on polyurethane (PU). The materials were compared using a novel testing method based on a rat tail-tip model. Tests were also performed with PU that was enriched with the procoagulant substance chitosan to evaluate if this could increase its hemostatic efficacy. Methods: The following topical hemostatic agents were compared using a rat tail tip model: Collagen, gelatin, oxidized regenerated cellulose, chitosan dressing, PU and PU with chitosan. The tail tip was fixated on a developed test device to ensure a constant and equal pressure of the test material on the wound. The mean bleeding time was determined and compared between the groups. Results: PU showed a mean bleeding time of 23.9 min. This was not significantly shorter or longer than gelatin (23.6 min), collagen (28.2 min) or oxidized regenerated cellulose (26.9 min). The addition of chitosan to PU did lead to the shortest mean bleeding time (21.5 min) but this was not significantly faster than PU without chitosan. Conclusions: These results show that PU is a promising alternative for the most widely used topical hemostatic agents. Future studies will have to show if the addition of procoagulant substances like chitosan can significantly improve the hemostatic efficacy of PU. Keywords: Hemostasis, Tail-tip, Collagen, Gelatin, Polyurethane 1 Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands 2 Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands 3 Haemoscan, Stavangerweg 23-23, 9723 JC Groningen, Netherlands Received: 28 May 2016 Accepted: 02 July 2016 *Correspondence: Dr. Ferdinand I. Broekema, E-mail: f.i.broekema@umcg.nl Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20162746