A Starchy Solution: Potatoes to Stop Bleeding?

A potato-based powder capable of instantly clotting blood holds potential for the treatment of everything from minor cuts to surgical incisions and even combat injuries, researchers reported at the American Society of Anesthesiologists annual meeting.

The novel hemostat (blood-clotting agent) also may one day help anesthesiologists reduce the need for surgical transfusions, a particular hazard of liver, heart, orthopedic, trauma and vascular surgeries, Mark H. Ereth, M.D., an anesthesiologist at Mayo Clinic in Rochester, Minnesota, said.

Methods of avoiding transfusions for patients are sought by anesthesiologists whenever possible because, although transfusions can save lives, they also carry the real risk of disease transmission and serious allergic reactions. Considering the massive numbers of people who undergo surgery each year, that risk translates into a large and costly problem, Dr. Ereth said. "Seventy percent of the 700,000 patients who have heart surgery each year receive up to one liter of blood during surgery," he said. "This hemostat won't eliminate transfusions, but it can limit bleeding and potentially limit transfusion of banked blood products thereby avoiding complications. It may also save precious health care resources."

Approved late last year by the United States Food and Drug Administration, the hemostat produces immediate coagulation at the surface of a wound, followed by normal blood-clotting processes.

Applied as a fine topical powder through a small, bellows-like reservoir called a puffer, the hemostat acts as an ultra-efficient, dehydrating "sponge" when applied to the bleeding source, soaking up water and blood plasma.

A Mayo Clinic study of 30 volunteers found that the coagulant with applied pressure produced instantaneous hemostasis (blood clotting) of small forearm incisions in 77 percent of incisions, compared to a median bleeding time of approximately six minutes at identical control incisions. To manage bleeding at the control sites one inch from the treatment site, the researchers applied pressure alone.

In addition to speed, the topical agent offers an attractive alternative to collagen-based and other animal-derived hemostats, which can cause mild to severe allergic reactions in some patients. Made of purified potato starch processed to produce porous, spherical micro-particles, the new coagulant eliminates this allergy risk.

The relatively large surface area of the particles gives the hemostat its extraordinary dehydrating action. At the same time, the small size of the individual microspheres allows the body's own enzymes to rapidly degrade the hemostat. According to laboratory findings, virtually all traces of the substance disappear within hours, Dr. Ereth noted.

"Of the many topical hemostats developed over the past 40 years, none has had as small a side effect profile as this one," he said. "At a cost much less than other coagulants, the agent appears to be economical as well."

In addition to stopping bleeding from minor lesions and oozing from surgical wounds, the coagulant has military applications, Dr. Ereth said.

Profuse bleeding from severe trauma can lead to death if not treated rapidly. Combat medical personnel must be deployed to apply continuous pressure to some injured soldiers' wounds until surgical repair is possible. By rapidly soaking up blood at the injury's surface, the hemostat may provide hemostasis, freeing medics to attend to other emergency duties, Dr. Ereth said. Recent laboratory studies suggest the powder can quickly, safely and effectively clot blood at the surface of severe wounds, he reported.

Anesthesiologists at Mayo Clinic have received approval for additional investigations to use the hemostat on patients having surgery of the heart, spleen, kidney or the soft tissue surrounding bones. Protocols for the hemostat's application in laparoscopic and thorascopic procedures are currently being developed.