Evidence Based Care

Evidence Based Care

Comparison of Celox powder and conventional dressing on hemostasis of vascular access site in hemodialysis patients

Document Type : Original Quantitative and Qualitative Research Paper

Authors
Hamid Chamanzari 1
Mahmood Choubdar 2
Farzaneh Sharifipour 3
Hasan Gholami 1
Fatemeh Daneshvari 4
1 In Structor of Nursing, Department of Medical –Sergical Nursing, School of Nursing and Midwifery ,Mashhad University of Medicine Sciences,Mashhad,Iran
2 MS in Intensive Care Nursing Student, School of Nursing and Midwifery, Mashhad University of Medicine Sciences, Mashhad, Iran
3 Assistant Professor of Nephrologist, School of Medicine, Mashhad University of Medicine Sciences, Mashhad, Iran
4 Expert of Nursing, Mashhad University of Medicine Sciences, Mashhad, Iran
10.22038/ebcj.2014.3657
Abstract
Background: Common measures to stop bleeding can run the risk of clotting and thrombosis due to prolonged application of pressure. Topical homeostatic agents have an important role in decreasing time to hemostasis and consequently prevention of the complications.  
Aim: the aim of this study was to compare Celox powder and conventional bandage on time to hemostasis in the vascular access site in hemodialysis patients.
Methods: This one-group, before-after, clinical-trial was conducted on 30 dialysis patients who had been selected by purposive sampling and underwent hemodialysis  through arteriovenous fistula in Imam Reza and Montaserieh  hospitals of Mashhad and Modarres hospital of Kashmar in 2013- 2014. The arteriovenous fistula puncture sites were treated with Celox powder dressing in three intermittent weeks. Time to hemostasis in each puncture site was calculated. Data were analyzed by repeated measures, Bonferroni correction, Friedman tests using SPSS version 11.5.
Results: The mean age of patients was 54.2 ±14.3, and most of them (53.3 percent) were male. Time to hemostasis in the vascular access sites of patients was 9.8±1.9 minutes. There was a significant difference in the hemostasis time between using 1 gram Celox powder and conventional dressing,(p<0/001). There was also a significant difference in time to hemostasis between utilizing 0.5 gram Celox powder and conventional dressing (p<0/001).
Conclusion: Using Celox powder reduces time to hemostasis in vascular access site in hemodialysis patient. Therefore, its use in patients with delayed vascular access site hemostasis is recommended.
Keywords
hemodialysis
Celox
Dressing
hemostasis
Vascular access
Subjects
  1. Boulanger H, Ahriz-Saksi S, Flamant M, Vigeral P. Evaluation of Post-Puncture Bleeding Time of Arteriovenous Fistulas with IRIS® Bandage. Age (years). 2013;68:22-88
  2. BachtellN, Goodell T, Grunkemeier G, Jin R, Gregory K. Treatment of Dialysis Access Puncture Wound Bleeding with Chitosan Dressings. Dialysis & Dransplantation. 2006;35(11):672-81
  3. Dickinson LK, Clark TW. Puncture Site Hemostasis in the Dialysis Unit.Reproduced with permission from Renal Business Today, March 2012
  4. Chawki M. Medical Device for a Puncture Site or Infusion Site. WO2010037922; 2010 
  5. Utterberg DS, Schnell WJ, Bell D. INJECTION AND HEMOSTASIS SITE. EP 1789118; 2007
  6. Ahlmen J, Goch J, Wrege U, Larsson R, Honkanen E, Althoff P, et al. Preliminary Results from the Use of New Vascular Access (Hemaport) for Hemodialysis. Hemodialysis International. 2003;7(1):73-104
  7. ZiauddinA. Lee J. Elivera H, et al.Use of Microporous Polysaccharide Particles in Prolonged Vascular Access Bleeding after Hemodialysis;Presented at the 35 th Annual Meeting of the American Society of Nephrology; Nov1-4;Philadelphia,pa.
  8. Bagheri A,VahedianM, Damanpak V, Hejazi F, Hosseinzadeh F, Irani R. Effectivness of Celox Powder and Standard Dressing in Control of Angiography Location Bleeding.Journal of Babol University of Medical Sciences(jbums). 2013;15(4):30-6 (Persian)
  9. Pozza M, Millner RW. Celox (chitosan) for Haemostasis in Massive Traumatic Bleeding: Experience in Afghanistan. European Journal of Emergency Medicine. 2011;18(1):31-3
  10. Millner RW, Lockhart AS, Bird H, Alexiou C. A New Hemostatic Agent: Initial Life-Saving Experience with Celox (chitosan) in Cardiothoracic Surgery. The Annals of Thoracic Surgery. 2009;87(2):e13-e4
  11. Koksal O, Ozdemir F, Cametoz B, Buyukcoskun NI, Sigirli D. Hemostatic Effect of a Chitosan Linear Polymer (Celox (R)) in a Severe Femoral Artery Bleeding Rat Model Under Hypothermia or Warfarin Therapy. Ulus Travma Acil Cerrahi Derg. 2011;17(3):199-204
  12. Lentini P, de Cal M, Chronopoulos A, Cruz D, Nalesso F, Garzotto F, et al. An innovative Technology for Safe Needle Disconnection after Hemodialysis. The Journal of vascular Access. 2010;12(3):239-43
  13. Brunner LSH SD. Text Book of Medical Surgical of Nursing. Tehran: Salemi Publication; 2008 (Persian)
  14. Ball LK. Fatal Vascular Access Hemorrhage: Reducing the Odds. Nephrology Nursing Journal. 2013; 40(4):297-303)
  15. Sandroni S. Venous Needle Dislodgement during Hemodialysis: An Unresolved Risk of Catastrophic Hemorrhage. Hemodialysis International. 2005;9(1):102-3