Corrigendum to “A Comparative Study of the Resorption and Immune Response for Two Starch-Based Hemostat Powders”: Journal of Surgical Research Volume 282, February 2023, Pages 210-224 (Journal of Surgical Research (2023) 282 (210–224), (S0022480422006047), (10.1016/j.jss.2022.09.022))

The authors note that text was omitted from the conclusions section of the published abstract. The full, corrected abstract is provided below: Abstract Introduction: Powder hemostats are valuable adjuncts to minimize intra-operative and post-operative complications. In addition to promotion of rapid coagulation, resorption and biocompatibility are desirable attributes. Plant starch-based polysaccharide hemostat powders are effective and widely used hemostatic agents, however their source and/or processing can affect characteristics such as in vivo degradability. For example, Arista™ is a purified/hydrolyzed starch powder that is rapidly resorbed in vivo; whereas PerClot® shows slow resorption and preservation of a crystalline form. Materials and methods: In the present study, we compared the cellular response to the hemostatic agents PerClot® and Arista™ both in vitro and in vivo, and used potato starch and urinary bladder extracellular matrix (UBM-ECM) as high crystallinity/slowly resorbable and pro-healing controls respectively. Results: All test articles and their degradation products were cytocompatible in vitro as measured by cell viability and metabolic activity of bone-marrow macrophages. PerClot® induced a stronger proinflammatory, M1-like macrophage response in vitro (p < 0.001) than Arista™, likely due to differences in source composition. Histologic examination of the in vivo surgical site showed the almost complete degradation of Arista™ after 12 hours (day 0), whereas both PerClot® and potato starch were still present at 28 days with crystals identifiable with polarized light microscopy and PAS staining. Macrophage phenotype in vivo showed no differences between PerClot® and Arista™. Collagen deposition and mononuclear cell accumulation consistent with an early foreign body response were present around PerClot® and potato starch crystals, whereas no such cell or connective tissue deposition was noted at the site of Arista™ or UBM-ECM placement. Conclusions: Results of the present study show distinct differences in the host response to two hemostatic powders, Arista™ and PerClot®. While both powders showed cytocompatible in vitro effects, PerClot® showed slow resorption and the local persistence of crystalline degradation products in vivo that were associated with the onset of chronic inflammation and an early foreign body response. The authors appreciate the opportunity to correct this error.