A sprayable hemostat containing fibrillar collagen, bovine thrombin, and autologous plasma

Background. A new sprayable hemostat, CoStasis hemostatic device (Cohesion Technologies Inc, Palo Alto, CA), consisting of collagen, thrombin, and autologous plasma was tested versus fibrin sealant and collagen hemostatic sponges. Performance was also monitored as fibrinogen and platelets were depleted from the plasma. In addition, the strength of the CoStasis gel, its sealing ability, its fibrillar structure, and its platelet-aggregating ability were investigated. Methods. Hemostatic performance was determined with an in vivo bleeding rabbit kidney and spleen model. Differential scanning calorimetry and electron microscopy were used to analyze collagen structure. Sealing ability was determined with a burst-test apparatus. Results. In the in vivo model, CoStasis was superior to fibrin sealant and collagen sponges in achieving a rapid time to hemostasis. The formulation continued to perform well when either platelets or fibrinogen was depleted. CoStasis formed weaker gels than fibrin sealant and could withstand only modest pressures. The collagen in the formulation had a fibrillar structure that was shown to aggregate human platelets. Conclusions. CoStasis, with the two platelet activators collagen and thrombin in addition to the thrombin-catalyzed formation of fibrin and the sealing properties of the soft gel, provides an excellent atraumatic hemostat.