According to research conducted at Columbia Presbyterian Medical Center and Columbia University Health Sciences, CoStasis surgical hemostat, manufactured by Cohesion Technologies Inc, reduced postsurgical bleeding as well as the need for nasal packing. CoStasis had the additional benefit of significantly reducing postsurgical discomfort, which can be substantial.
The findings were reported by the study's author, Jeffrey Ahn, director of Sleep Disorder Surgery at the Columbia Presbyterian Medical Center of New York-Presbyterian Hospital and assistant professor of Otolaryngology and Head and Neck Surgery at Columbia University College of Physicians & Surgeons.
More than 30 million Americans suffer from sinusitis, an inflammation of any or all of the four air-filled cavities in the bones of the forehead, nose and upper jaw. The sinuses clean the air we breathe by producing mucus to clear away bacteria, dust and other inhaled pollutants. Patients with sinusitis also usually have significant nasal obstruction due to a defect in anatomy, such as a deviated septum. When sinusitis becomes serious, surgery to enlarge the sinus openings to help drainage is often the only option. More than 200,000 such procedures are performed each year in the U.S. One of the main complications is postsurgical bleeding. Nasal packing prevents this complication; however, significant patient discomfort is usually the result.
CoStasis is composed of collagen and thrombin -- two potent platelet activators -- combined with the patient's own plasma. The collagen and thrombin are derived from controlled bovine sources in the U.S. In addition to being a potent platelet activator (platelets in the blood help to stop bleeding), the thrombin also reacts with the patient's own plasma (collected at the time of surgery) to initiate and enhance the conversion of fibrinogen to fibrin (another bleeding inhibitor) in the body. This fibrin network combines with the collagen to create a gel matrix to inhibit blood flow. Studies have shown that this matrix is reabsorbed by the body within 60 days.
Although there are other alternatives to traditional nasal packing, the CoStasis spray is the only one to utilize the patient's own plasma, eliminating the risk of human blood-transmitted diseases. "These other options use pooled blood sources, which can be a concern for both surgeons and patients," Dr. Ahn noted.
Dr. Ahn's study compared the use of traditional nasal packing to CoStasis in 30 patients with chronic sinusitis confirmed by computed tomography (CT). Fifteen patients were in each group. Those in the CoStasis group also had a nominal 15ccs of blood drawn following the induction of general anesthesia, which was centrifuged and then the plasma was added to the two-syringe delivery system. At the conclusion of the surgical procedure, patients received either nasal packing or the CoStasis topical spray to control postsurgical bleeding.
Patients were examined one week after their surgery and recorded their postsurgical symptoms of nasal congestion, headache, pain and discomfort on a numerical scale ranging from zero to 10. Zero represented no pain/discomfort, while 10 represented the worst.
All of the patients in the nasal packing group reported postsurgical nasal congestion and headache; the mean pain/discomfort score was seven. In contrast, only eight of the patients in the CoStasis group experienced nasal congestion; six reported headache. The mean postsurgical pain/discomfort score for this group was one. No postsurgical bleeding complications were found in either group.