Search Results (2)

Hemostatic powder (HP) is a relatively recent addition to the arsenal of hemostatic endoscopic procedures (HEPs) for gastrointestinal bleeding (GIB) due to benign and malignant lesions. Five types of HP are currently available: TC-325 (Hemospray™), EndoClot™, Ankaferd Blood Stopper^®, and, more recently, UI-EWD (Nexpowder^TM) and CEGP-003 (CGBio™). HP acts as a mechanical barrier and/or promotes platelet activation and coagulation cascade. HP may be used in combination with or as rescue therapy in case of failure of conventional HEPs (CHEPs) and also as monotherapy in large, poorly accessible lesions with multiple bleeding sources. Although the literature on HP is abundant, randomized controlled trials are scant, and some questions remain open. While HP is highly effective in inducing immediate hemostasis in GIB, the rates of rebleeding reported in different studies are very variable, and conditions affecting the stability of hemostasis have not yet been fully elucidated. It is not established whether HP as monotherapy is appropriate in severe GIB, such as spurting peptic ulcers, or should be used only as rescue or adjunctive therapy. Finally, as it can be sprayed on large areas, HP could become the gold standard in malignancy-related GIB, which is often nonresponsive or not amenable to treatment with CHEPs as a result of multiple bleeding points and friable surfaces. This is a narrative review that provides an overview of currently available data and the open questions regarding the use of HP in the management of non-variceal upper GIB due to benign and malignant diseases. Full article

Ankaferd Blood Stopper® (ABS) offered as a hemostatic agent is a standardized herbal extract obtained from five different plants. The effects of ABS on colonic anastomosis are unknown. This study was designed to assess potential effects on the anastomosis of left colon in an experimental animal model. Thirtytwo male Wistar albino rats were randomized into two groups and subjected to colon anastomosis. The study group subjected to colon anastomosis with topical application of ABS to control of mucosal bleeding at the cut ends of the colon, and the control group subjected to colon anastomosis only. The rats were killed 3 and 7 days postoperatively. Four types of assessment were performed: bursting pressure, bursting wall tension, histopathology, and biochemical analysis. Compared to the control group, ABS used rats displayed a higher bursting pressure (p < 0.05) and anastomotic hydroxyproline content (p < 0.05). The use of ABS leads to a significant decrease in malondealdehyde levels (p < 0.05) and increase in paraoxonase activity (p < 0.05) at both time points. Histopathological analysis revealed that the use of ABS improves anastomotic healing in terms of reepithelialization, increased neovascularization, diminished ischemic necrosis, and inflammatory infiltration to muscle layer. Topical application of ABS to control of mucosal bleeding at the cut ends of the colon significantly improve the anastomotic wound healing by means of increasing mechanical strength and amount of tissue HPL level. Full article