APPLICATION OF A BIOCOMPATIBLE, SYNTHETIC PEPTIDE GEL

Abstract

PuraStat^Ⓡ—a self-assembling peptide solution—has been recently approved and marketed in Japan as a hemostatic agent for gastrointestinal endoscopy. It is an artificial synthetic peptide consisting of three amino acids: arginine (R), alanine (A), and aspartic acid (D). After coming in contact with body fluids, the peptides change from acidic to neutral, self-assembling into gel aggregates and acting as a medical device for pressure hemostasis of bleeding points. PuraStat^Ⓡ is ineffective against spurting bleeding and can only be used for oozing. However, compared with the conventional hemostatic agents, PuraStat^Ⓡ has the following advantages: stays as a gel for a long time at the application site; is a transparent substance easily removable by washing, and therefore, does not interfere with subsequent procedures after application; and has a low risk of infection. PuraStat^Ⓡ can help with hemostasis of intraoperative bleeding in ESD, prevent postoperative bleeding, promote wound healing, and act as a hemostatic agent for gastrointestinal bleeding. This article outlines an endoscopic hemostatic technique using PuraStat^Ⓡ.