A novel haemostatic agent based on self-assembling peptides in the setting of nasal endoscopic surgery, a case series

M F Lee; Z Ma; A Ananda

doi:10.1016/j.ijscr.2017.11.024

A novel haemostatic agent based on self-assembling peptides in the setting of nasal endoscopic surgery, a case series

Int J Surg Case Rep. 2017 Nov 20:41:461-464. doi: 10.1016/j.ijscr.2017.11.024. eCollection 2017.

Authors

M F Lee¹, Z Ma², A Ananda³

Affiliations

¹ Royal Prince Alfred Hospital, 50 Missenden Rd, Camperdown, NSW, 2050, Australia. Electronic address: 94michaellee@gmail.com.
² Royal Prince Alfred Hospital, 50 Missenden Rd, Camperdown, NSW, 2050, Australia. Electronic address: zhi1992@gmail.com.
³ Royal Prince Alfred Hospital, 50 Missenden Rd, Camperdown, NSW, 2050, Australia. Electronic address: info@drananda.com.au.

Abstract

Introduction: Recently, a novel purely synthetic topical haemostatic agent (PuraStat^®) has been proposed in surgery based on the self-assembling tendency of some repeating peptide sequences. This transparent, ready to use hydrogel appears suitable for use in FEES with low rates of post-operative re-bleeding and adhesion formation.A first series of 60 patients experiencing endonasal powered turbinoplasty across various hospitals in Sydney using PuraStat^® was observed for postoperative re-bleeding and adhesion formation.

Discussion: In all 60 patients, no post-operative re-bleeding was observed, while healing went well in absence of adhesion formation. Effective haemostasis with PuraStat^® is well documented in other surgical fields, but its use in FEES and adhesion prevention is relatively novel.

Conclusion: Synthetic self-assembling peptides appear to be indicated in this area. Further studies are needed to confirm their potential for adhesion prevention.

Keywords: Endonasal surgery; Endoscopic nasal surgery; Endoscopic turbinoplasty; FEES, Functional Endoscopic Endonasal Surgery; Haemostasis; PuraStat; RADA, short peptide made of 4 amino acids (Arginine-Alanine-Aspartic acid-Alanine) repeated 4 times.