FloSeal Matrix: new generation topical hemostatic sealant.

Abstract

Application of direct pressure at a bleeding site frequently provides either complete control of bleeding or adequate control to enable more definitive measures to be taken. However, this method of controlling bleeding may not be sufficient when the source of bleeding is hard to identify, as may be the case for diffuse venous bleeding, or when an inherent coagulopathy is present. Intraoperative coagulopathy, which can be induced by a variety of factors including hemodilution1-4 and hypothermia,1,5,6 may be treated with active hemostatic agents. Hemostasis is also compromised due to the presence of antiplatelet and anticoagulation agents, especially in patients undergoing cardiac or vascular surgery, as well as from changes associated with cardiopulmonary bypass.7-10 In such cases topical hemostatic agents become useful adjuncts to the conventional methods of achieving hemostasis. A comprehensive list of currently available topical hemostatic agents, together with their key attributes is presented in Table 1. The present article discusses the properties and uses of one such topical hemostatic agent, FloSealTM Matrix Hemostatic Sealant (FloSeal), which has proved its utility in addressing problematic bleeding during surgery in a variety of procedures and anatomical sites.11-15 FloSeal represents the new generation of topical hemostatic agents made from collagen or gelatin. FloSeal is prepared by mixing together a proprietary gelatin matrix and topical thrombin im-