The hemostatic effect of traditional class Ⅲ hemostatic powder and aggregate absorbable hemostat in surgeries: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

DA Xi’ao ^1,2 , GUO Qiong ^1,3 , XIE Yanling ^1,4 , GU Xianlin ^1,5 , LONG Youlin ^1,5 ,  LI Zhengchi ^5,6 ,  HUANG Jin ¹ ,  DU Liang ^1,3,5,6

1. Innovation Institute for Integration of Medicine and Engineering, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P. R. China;
3. West China Medical Publishers, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
4. West China School of Public Health, Sichuan University, Chengdu 610041, P. R. China;
5. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
6. Center for Education of Medical Humanities, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

LI Zhengchi, Email: zhengchili@scu.edu.cn; HUANG Jin, Email: michael_huangjin@163.com; DU Liang, Email: duliang0606@vip.sina.com

Keywords：

Surgery; Traditional class Ⅲ hemostatic powder; Aggregate absorbable hemostat; Hemostatic effect; Systematic review

DOI：

10.7507/1672-2531.202502041

Video：

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Objective To systematically review the hemostatic effect of traditional class Ⅲ hemostatic powder and aggregate absorbable hemostat in surgeries. Methods The PubMed, Embase, CENTRAL, CNKI, VIP and WanFang Data databases were electronically searched to collect controlled studies related to the objectives from inception to September 18^th, 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. Results A total of 7 randomized controlled trials, 5 cohort studies and 9 animal experiments were included. The results of analysis showed that the group with traditional class Ⅲ hemostatic powder or aggregate absorbable hemostat had a higher hemostatic success rate and shorter hemostatic time than those with no hemostatic material in animal surgeries. And the group with aggregate absorbable hemostat had a higher 10 min hemostatic success rate than those with traditional hemostatic measures. The application of traditional class Ⅲ hemostatic powder in human cardiothoracic surgeries shortened the hemostatic time and reduced drainage after surgeries, but caused more blood loss during knee arthroplasties. Aggregate absorbable hemostat caused less blood loss than traditional hemostatic measures in human hip arthroplasties, and the 5 min and 10 min success rates of aggregate absorbable hemostat group were not worse than those of hemostatic gauze. Conclusion Current evidence shows that the hemostatic effect of both traditional class Ⅲ hemostatic powder and aggregate absorbable hemostat are better than that of no hemostatic material in animal and human surgery, but the comparison results between the two and with other hemostatic measures are still not clear. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

Citation： DA Xi’ao, GUO Qiong, XIE Yanling, GU Xianlin, LONG Youlin, LI Zhengchi, HUANG Jin, DU Liang. The hemostatic effect of traditional class Ⅲ hemostatic powder and aggregate absorbable hemostat in surgeries: a systematic review. Chinese Journal of Evidence-Based Medicine, 2025, 25(8): 909-917. doi: 10.7507/1672-2531.202502041 Copy

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5. Matonick JP, Hammond J. Hemostatic efficacy of EVARREST™, Fibrin Sealant Patch vs. TachoSil® in a heparinized swine spleen incision model. J Invest Surg, 2014, 27(6): 360-365.
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7.
8. Schleckser P. The SURGICEL® powder mild or moderate parenchymal or soft tissue intraoperative bleeding (China study). 2018.
9. 中华人民共和国国务院. 医疗器械监督管理条例. 2021.
10. 国家药品监督管理局. 可吸收再生氧化纤维素止血颗粒获批上市. 2022.
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12.
13.
14.
15.
16.
17. NCT. The effect of arista on post-operative bleeding and wound drainage following mastectomy. 2018.
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31. Björses K, Holst J. Topical haemostatics in renal trauma--an evaluation of four different substances in an experimental setting. J Trauma, 2009, 66(3): 602-611.
32. Ereth MH, Schaff M, Ericson EF, et al. Comparative safety and efficacy of topical hemostatic agents in a rat neurosurgical model. Neurosurgery, 2008, 63(4 Suppl 2): 369-372.
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36. Shao H, Wu X, Xiao Y, et al. Recent research advances on polysaccharide-, peptide-, and protein-based hemostatic materials: a review. Int J Biol Macromol, 2024, 261(Pt 1): 129752.
37. Wolny Y, Tam T. Review of hemostatic agents used in robotic assisted laparoscopic gynecological surgeries. J Minim Invasive Gynecol, 2012, 19(6 Suppl 1): S167-S168.
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39.

Chinese Journal of Evidence-Based Medicine

The hemostatic effect of traditional class Ⅲ hemostatic powder and aggregate absorbable hemostat in surgeries: a systematic review

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