The more things change, the more they remain the same. We are once again employing the wisdom of the ancients to lead the way in medicine today.

 

The medicinal use of leeches, vilified as quackery, is now standard treatment for certain blood disorders. Maggots are once again being used to eliminate dead tissue to aid the healing of massive skin trauma.

 

In March I posted about scorpion venom used to identify cancer cells and help surgeons completely remove all of a tumor without worry of leaving cancer cells behind. Well, now it appears the venom of the Fer-de-Lance, a deadly snake, can save lives during surgery. A chemical in the snake’s venom coagulates blood and instantly helps stop bleeding during surgical procedures.

 

About the Fer-de-Lance

 

Fer-de-lance is one of many common names for a type of pit viper that inhabits the rain forests of Mexico and South America. It kills its prey—small rodents, reptiles and birds—with its poisonous bite. Once in the victim’s body, the venom instantly causes massive blood clotting, literally turning the blood vessels into jelly filled tubes. The prey quickly dies within close proximity to the snake. It is this rapid clotting property of the venom that interested a Rice University chemist, Dr. Jeffrey Hartgerink.

 

Fer-de-Lance Venom for Hemorrhage Control

 

In both human medicine and veterinary medicine, hemorrhage is a constant concern. Procedures that involve the heart, liver, and kidneys are particularly prone to excessive post-surgical bleeding.

 

This is particularly true in human medicine for patients taking anti-coagulating drugs, like myself. Daily, I take warfarin tablets (the active ingredient in rat poison) to control my deep vein thrombosis. For an unknown reason, my body forms clots in my veins that have blocked the major vein in my left leg and partially blocked the major vein in my right leg. I have also had times when small clots, or emoboli, have lodged in my lungs, causing me to be short of breath and weak. The daily warfarin keeps my blood “thin” so that these emboli are less likely to form.

 

The problem arises when I need a surgical or dental procedure. I recently had a cyst removed from my head. I had to discontinue the warfarin for one week so I would not bleed excessively during and after the cyst removal procedure. Well, what if something major happened and I needed immediate surgery? This scenario is common in hospitals today. There just isn’t time to withdraw the warfarin.

 

That’s where Dr. Hartgerink’s findings come in. He and his colleagues incorporated batroxobin, the active ingredient in the Fer-de-Lance’s venom, into a gel. Their goal was to have a product that would instantly clot blood yet not leak into the blood stream, causing generalized clotting.

 

They experimented with their product on procedures involving the liver in rats. Because of its vascularity (i.e., the vessels that conduct blood and fluids through the body), surgery and biopsies of the liver tend to bleed and bleed and bleed. Dr. Hartgerink’s gel stopped liver hemorrhages within 5-6 seconds without any harmful systemic effects, even in rats that were on high doses of warfarin.

 

They compared their gel to other standard coagulating gels and foam pads and found they took anywhere from 19 seconds to 2 minutes to stop the bleeding.

 

Other than blood loss, stopping bleeding quickly offers another advantage in surgery: visibility. Surgery is often complicated because the constant bleeding causes pools to accumulate, which obscures visualization and makes proceeding difficult. Instant clotting would be a tremendous help.

 

So far Dr. Hartgerink’s results are restricted to rats, but hopefully will be tested soon on other animals and humans. Personally I can’t wait for the veterinary product to be available.

 

Have you had a pet saved during surgery by products that controlled bleeding? Share your experience in the comments.

 

 

Dr. Ken Tudor