Selten, M.H.A. (2009) Een pilotstudie naar biodegradeerbaar polyurethaanschuim gemodificeerd met 55% polyethyleenglycol (PEG) als lokaal hemostaticum na gebitsextracties. thesis, Dentistry.
![[img]](https://umcg.studenttheses.ub.rug.nl/style/images/fileicons/text.png) |
Text
Selten.pdf Restricted to Registered users only Download (31MB) |
Abstract
Background: Haemostatic disorders may cause excessive bleeding after dental extraction. Gelatine and collagen are widely used haemostatic agents. Disadvantages of these products are their poor mechanical properties after wetting and their animal derived origin. Polyurethane foam is fully synthetic and biodegradable and has a porosity of 97%. The goal of this study was to asses the feasibility of a newly developed polyurethane foam as a local haemostatic agent in sockets after dental extraction. Patients and Methods: The study design of this pilot was a split mouth experiment in 10 patients. Only healthy patients were included, who had to undergo at least 2 dental extractions in one session. The patients were randomly included in 2 groups of 5 patients each. In the first group, a polyurethane foam was applied in the one extraction socket, while in the other extraction socket a commercially available gelatine foam (Willospon~ was applied. In the second group, a polyurethane foam was applied in the one extraction socket, while a collagen wadding (Novacol®) was applied in the other extraction socket. All agents were removed from the sockets after 2 minutes, and stored in 200J.1l O.IM EDTA. The degree of coagulation in the different haemostatic agents was measured using ELISA thrombine-antithrombine-test and ELISA fibrinogen. Furthermore the toxicity (haemolysis) of the different haemostatic agents was tested in vitro, by measuring the free hemoglobin after 24 hours incubation with washed erythrocytes. Results: Polyurethane foam keeps its mechanical properties like a soft sponge after wetting. It showed the highest concentration of thrombin/antithrombinlll (TAT-III), with an average concentration of 2.5 JJ.g/ml ± 0,05 ( mean ± SD) in the gelatin group, and with an average of 2,2 JJ.g/ml± 0,9 in the collagen group, which represented the highest haemostasis within the different foams. Gelatine and collagen showed an average TAT concentration of 2,2 f.lg/ml ±1,0, respectively 1,4 f.lg/ml ± 0,8. The lowest concentration of plasma fibrinogen was found in the polyurethane foam (1,4 mg/ml± 0,1) which also indicates the highest coagulation within the tested agents. Polyurethane foam showed 0,81% haemolysis, gelatin 1,5 7% and collagen 8,6%. Conclusion: This study indicates that polyurethane foam has a better haemostatic capacity and less toxicity than some other commercial available local haemostatic agents, gelatine and collagen. A future study with a higher number of patients will have to prove the statistical significance of the promising haemostatic capacity of the polyurethane foam.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: and Bos, Prof. Dr. R.R.M. and Afdeling: Kaakchirurgie, UMCG |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:57 |
| Last Modified: | 25 Jun 2020 10:57 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1723 |
Actions (login required)
 |
View Item |