Biosurgicals and Trauma

Abstract

Hemorrhage plays a prominent role in the outcome of trauma patients, from initial injury, through resuscitation, and stabilization. Biosurgicals have recently drawn attention to both the control of bleeding and chronic wound management. However, their role will be examined here in the context of adjuncts to control preoperative, intraoperative, and postoperative bleeding in trauma. A review of the scientific literature relevant to the use of passive and active topical hemostatic devices, as well as systemic pharmacologic agents, for control of hemorrhage is provided, in both military and civilian contexts. Bibliometric publication patterns and published guidelines are examined to identify the range of individual products available and the degree of attention they receive in the management of acute traumatic injuries. It is imperative that the evidentiary basis for the use of these agents be weighed against their cost and potential risks.

Biosurgical Materials in Neurosurgical Applications: From Pioneers to Leaders

“…It is important to realize that biosurgical agents are adjuncts to hemostasis when standard methods like direct pressure, suturing, or cautery are impractical or ineffective [107,108]. Good knowledge of the mechanism of action of different available biosurgical hemostats is critical, with multiple considerations including the patient's anticoagulation status, the rate of bleeding, the presence of thrombocytopenia, fibrinogen level assessment, and many other factors.…”