Post written by Maham Hayat, MD, and Dennis Yang, MD, from the Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA.

This study aimed to evaluate the use of UI-EWD (Nexpowder; Medtronic, Minneapolis, Minn, USA), a novel hemostatic powder, for prophylaxis of delayed bleeding (DB) after endoscopic submucosal dissection (ESD) in the upper and lower GI tract.

DB remains a significant adverse event after ESD, particularly for large lesions where complete mucosal closure is technically challenging. Hemostatic powders such as UI-EWD have the potential to address these challenges by providing an adhesive hydrogel barrier that can be easily applied over the resection defect.

Our study found that UI-EWD was easy to use, achieved high technical success, and was associated with a low rate of DB (3.6%) after ESD throughout the GI tract.

Although our initial results are promising, additional research is needed to confirm the stability and durability of the hydrogel, especially in relation to factors such as lesion size and location within the GI tract. Future comparative trials are necessary to determine the role of hemostatic topical agents versus other established methods of DB prevention, as well as to evaluate its cost-effectiveness and long-term outcomes.

A, UI-EWD hemostatic system (Nexpowder; Medtronic, Minneapolis, Minn, USA) with powder vial, spray body, and delivery catheter. B and C, After endoscopic submucosal dissection (ESD), the UI-EWD hemostatic powder is sprayed over the entire ESD mucosal defect under direct visualization. D, The hemostatic powder immediately forms an adhesive hydrogel over the tissue on contact with fluid.

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