Local Haemostasis and Soft Tissue Regeneration

A controlled and efficient local haemostasis can be of critical importance in emergencies and during surgical interventions. In case of major bleedings, quick therapeutic measures are of uttermost importance. Modern state of the art haemostatic products allow a quick control of haemorrhages and a decrease of the blood loss. They are capable of filling larger tissue defects and efficiently suppress wound bleeding in many clinical situations.

The research group around Paul Slezak and Rainer Mittermayr researches mechanisms of local haemostasis that reach from molecular basics to material development and the clinical application. Emphasis is put on the development of new haemostatic products as well as new approaches to tissue and wound sealing. Further research areas are:

  • Wound sealing with biological and synthetic materials
  • Combination of haemostatic and tissue regenerative approaches for haemostasis
  • Optimizing the local haemostasis
  • Development of new experimental models to examine various aspects of pathological wound healing (e.g. ischemia)
  • Chronic wounds of different entity (e.g. on diabetic background)
  • Application of growth factors and cytokines (free or bound to scaffolds) or cell therapeutic approaches to chronic wounds to influence the healing cascade
  • Examination of physical alternatives to support the healing of the soft tissue

An important substance in local haemostasis is fibrin. Fibrin is produced as an end product during the coagulation cascade which is why a natural sealing glue was developed based on fibrin to ensure a quick haemostasis. Fibrin glue is very biocompatible and naturally degraded in the body, which makes it an important part of clinical routines. The group was and is instrumental in developing and perfecting the fibrin glue technology as well as the specific sprayers for the clinical application.

Special emphasis is put on the research of non-invasive physical techniques that should positively influence wound healing. This includes for example extracorporeal shock wave treatment which leads to an activation of endogenous regenerative power. A positive impact on the recruitment of stem cells to the location of the wound could be observed. Another method is low level light therapy, where light is used to accelerate the healing process and to improve the blood flow in the tissue.

Selected Publications

Firouz B, Faihs L, Slezak P, Ghaffari Tabrizi-Wizsy N, Schicho K, Winter R, Kamolz LP, Dungel P (2023). Testing the effects of photobiomodulation on angiogenesis in a newly established CAM burn wound model. Sci Rep. 2023 Dec 27;13(1):22985. 
(free PDF)

Hofmann AT, Slezak P, Neumann S, Ferguson J, Redl H, Mittermayr R (2023). Ischemia Impaired Wound Healing Model in the Rat-Demonstrating Its Ability to Test Proangiogenic Factors. Biomedicines. 2023 Mar 28;11(4):1043.
(free PDF)

Dungel P, Sutalo S, Slezak C, Keibl C, Schädl B, Schnidar H, Metzger M, Meixner B, Hartmann J, Oesterreicher J, Redl H, Slezak P (2023). Wavelength-Dependent Effects of Photobiomodulation for Wound Care in Diabetic Wounds. Int J Mol Sci. 2023 Mar 20;24(6):5895. 
(free PDF)

Strickland AD, Lang C, Manhartseder S, Reichsoellner R, Valliant E, Schädl B, Gulle H, Slezak P (2023) In vitro and Ex vivo Assessments of the Compatibility of Fibrin Sealant with Antimicrobial Compounds. Surg Infect (Larchmt). 2023 Feb;24(1):82-90.

Faihs L, Firouz B, Slezak P, Slezak C, Weißensteiner M, Ebner T, Ghaffari Tabrizi-Wizsy N, Schicho K, Dungel P (2022) A Novel Artificial Intelligence-Based Approach for Quantitative Assessment of Angiogenesis in the Ex Ovo CAM Model. Cancers (Basel). 2022 Sep 1;14(17):4273. 
(free PDF)

Slezak C, Flatscher J, Slezak P (2022) A Comparative Feasibility Study for Transcranial Extracorporeal Shock Wave Therapy. Biomedicines. 2022 Jun 20;10(6):1457. 
(free PDF)

Mittermayr R, Haffner N, Eder S, Flatscher J, Schaden W, Slezak P, Slezak C (2022) Safe and Effective Treatment of Compromised Clavicle Fracture of the Medial and Lateral Third Using Focused Shockwaves. J Clin Med. 2022 Apr 2;11(7):1988. 
(free PDF)

Slezak P, Keibl C, Labahn D, Schmidbauer A, Genyk Y, Gulle H (2021) A Comparative Efficacy Evaluation of Recombinant Topical Thrombin (RECOTHROM ®) With A Gelatin Sponge Carrier Versus Topical Oxidized Regenerated Cellulose (TABOTAMP ®/SURGICEL ®) In A Porcine Liver Bleeding Model. J Invest Surg2021 Aug;34(8):862-868.

Slezak P, Keibl C, Redl H, Labahn D, Heinz Gulle H (2020) An Efficacy Comparison of Two Hemostatic Agents in a Porcine Liver Bleeding Model: Gelatin/Thrombin Flowable Matrix versus Collagen/Thrombin Powder. J Invest Surg. 2020 Oct;33(9):828-838.

Slezak P, Klang A, Ferguson J, Monforte X, Schmidt P, Bauder B, Url A, Osuchowski M, Redl H, Spazierer D, Gulle H (2020) Tissue reactions to polyethylene glycol and glutaraldehyde-based surgical sealants in a rabbit aorta model. J Biomater Appl. 2020 Apr;34(9):1330-1340.
(free PDF)

Slezak P, Keibl C, Redl H, Labahn D, Gulle H. (2019) An Efficacy Comparison of Two Hemostatic Agents in a Porcine Liver Bleeding Model: Gelatin/Thrombin Flowable Matrix versus Collagen/Thrombin Powder. J Invest Surg. 2019 Mar 24:1-11.

Heher P, Ferguson J, Redl H, Slezak P. (2018) An overview of surgical sealant devices: current approaches and future trends. Expert Rev Med Devices. 2018 Oct;15(10):747-755.

Slezak P, Monforte X, Ferguson J, Sutalo S, Redl H, Gulle H, Spazierer D. (2018) Properties of collagen-based hemostatic patch compared to oxidized cellulose-based patch. J Mater Sci Mater Med. 2018 May 23;29(6):71.
(free PDF)

Heher P, Mühleder S, Mittermayr R, Redl H, Slezak P. (2018) Fibrin-based delivery strategies for acute and chronic wound healing. Adv Drug Deliv Rev. 2018 Apr;129:134-147.

Slezak P, Heher P, Monforte X, Keibl C, Redl H, Spazierer D, Gulle H. (2018) Efficacy of Topical Hemostatic Agents: A Comparative Evaluation of Two Gelatin/Thrombin-Based Hemostatic Matrices in a Porcine Kidney Surgical Model. J Invest Surg. 2018 Mar 21:1-8.

Zipperle J, Schlimp Ch J, Holnthoner W, Husa A-M, Nürnberger S, Redl H & Schöchl H (2013). A novel coagulation assay incorporating adherent endothelial cells in thromboelastometry. Thrombosis and Haemostasis, 109(5):869-877.

Coenye K, Bourgain C, Keibl C, Nürnberger S & van Griensven M (2013). Qualitative Morphological Comparison of Two Haemostatic Agents in a Porcine Liver Trauma Model. Surgical Science, 4:359-364.