Topical Hemostatic Agents

Abstract

Accurate hemostasis during neck surgery plays a key role in achieving successful patient’s outcome. In addition to traditional hemostatic methods, several topical hemostatic agents (THA) and tissue adhesives (TA) have been recently developed to reduce time in operating room and complications. THA may decrease intraoperative bleeding and facilitate modern surgical technologies such as minimally invasive surgery, video-assisted, endoscopic and robotic procedures. A large number of commercial and blood bank prepared fibrin sealants are commonly used in a variety of surgical settings (biologically active agents, active hemostatics): these products are somehow similar in composition but actually vary widely as to components and preparation methods. THA include physical passive agents (such as cellulose-based hemostatic agents, gelatin-based hemostatic agents and collagen-based hemostatic agents), sealants (TA, such as cyanoacrylates, PEG – polyethylene glycol hydrogels, glutaraldehyde-albumina sealants), and Combined products. Adverse effects and complications from THA and TA are generally uncommon. The ideal hemostatic should be safe, effective, practical, and cost-effective. The choice of which THA to use depends upon the character, amount, and location of bleeding; type of surgical procedure; the availability of a given agent; cost considerations; and surgeon preference and habits. Surgeons should be familiar with THA to ensure an optimal use in theater.