{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:43:45Z","timestamp":1759970625739,"version":"build-2065373602"},"reference-count":21,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Operative blood loss is strongly correlated with morbidity and mortality in surgery. Various hemostatic agents are used to reduce bleeding in cardiothoracic procedures. We report our experience with a plant-based microporous polysaccharide hemostatic powder (Starsil\u00ae Hemostat, Hemostat Medical GmbH, Velen, Germany). Materials and Methods: Data were collected retrospectively from 65 patients who underwent cardiac surgery at our institution from January 2012 to January 2015 with (n = 42) or without (n = 23; control group) the use of the hemostat powder. Primary endpoints were safety (e.g., laboratory parameters, adverse events, and infection parameters) and time to hemostasis when the hemostat powder was used. Other endpoints included operation time, hospitalization, quantity of the hemostat powder applied, and length of stay in the intensive care unit. Results: The 65 patients (49 male:16 female) analyzed in the study underwent 65 cardiothoracic procedures, including off-pump coronary artery bypass grafts (n = 25), on-pump coronary artery bypass grafts (n = 6), valve procedures (n = 6), valve procedures in combination with bypass grafts (n = 7), and others (n = 21). The application of the hemostat powder did not increase adverse events. The laboratory parameters did not exceed the expected range after heart surgery in both groups. The hemostat powder had no significant impact on the laboratory parameters compared to the control group. Blood control was sufficient and was rated by surgeons from good to very good on a visual analog scale (VAS) from 1 (very bad) to 10 (very good) [VAS = 8.3 \u00b1 1.2]. Intraoperative hemostasis was possible in nearly all patients. The hemostat powder led to satisfactory bleeding control within 2 min in 88% of cases. Five patients needed a second 5 g unit of the hemostat powder. Conclusions: The observed parameters between groups did not differ significantly. Therefore, the use of Starsil\u00ae Hemostat in cardiothoracic surgery is safe and effective bleeding control was achieved.<\/jats:p>","DOI":"10.3390\/medicina61020230","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T06:39:51Z","timestamp":1737959991000},"page":"230","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Use of Ultra-Hydrophilic Absorbable Polysaccharide for Bleeding Control in Cardiothoracic Surgical Procedures"],"prefix":"10.3390","volume":"61","author":[{"given":"Dow","family":"Rosenzweig","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Artemed Klinikum M\u00fcnchen S\u00fcd, 81379 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Lamm","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Artemed Klinikum M\u00fcnchen S\u00fcd, 81379 Munich, Germany"},{"name":"Department of Cardiac Surgery, University of Munich, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University of Munich, 81377 Munich, Germany"},{"name":"Cardiovascular Research Unit, Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, Cape Town 7700, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferdinand","family":"Vogt","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Artemed Klinikum M\u00fcnchen S\u00fcd, 81379 Munich, Germany"},{"name":"Department of Cardiac Surgery, Paracelsus Medical University Nuremberg, 90419 Nurnberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1111\/j.1537-2995.2004.04144.x","article-title":"The independent association of massive blood loss with mortality in cardiac surgery","volume":"44","author":"Karkouti","year":"2004","journal-title":"Transfusion"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1007\/s13304-021-01136-x","article-title":"An international multidisciplinary peer-driven consensus on the optimal use of hemostatic powders in surgical practice","volume":"73","author":"Eden","year":"2021","journal-title":"Updates Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1007\/s00104-006-1289-x","article-title":"M\u00f6glichkeiten der lokalen und systemischen Blutstillung bei chirurgischen Eingriffen [Local and systemic hemostasis in surgery]","volume":"78","author":"Bechstein","year":"2007","journal-title":"Chirurg"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.ejcts.2007.07.020","article-title":"Fibrin glue in coronary artery bypass grafting operations: Casting out the devil with Beelzebub?","volume":"32","author":"Lamm","year":"2007","journal-title":"Eur. 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