Clinical benefits and risk analysis of topical hemostats: a review

Abstract

A variety of local hemostats including absorbable gelatin sponge, collagen hemostat, and oxidized cellulose are commercially available. Local hemostats are applied when cautery, ligature, or other conventional hemostatic method is impractical. Proper handling is essential to control bleeding and only the required amount should be used, even though the hemostat is expected to dissolve promptly. A dry local hemostat absorbs body fluid of several times its own weight and expands postoperatively. Therefore, when an absorbable hemostatic agent is retained on or near bony or neural spaces, the minimum amount should be left after hemostasis is achieved. Documentation is important with regard to the hemostat used, including the name of the agent, site, and amount. This information is used as a reference in the interpretation of postoperative diagnostic images, since retained hemostat may sometimes mimic an abscess or recurrent tumor. The antigenicity of collagen is known to be low because of homology. When the safety of collagen was evaluated, the incidence of positive reactions was reported as 3.0%, and collagen may cause allergic reactions. Minimum inflammation without strong foreign body reactions or blockade of healing is desirable after the use of local hemostats. Strong foreign body reactions, chronic inflammation, and infections can cause granuloma formation after local hemostat use. By using local hemostats, it is possible to improve the condition of the patient, reduce complications, and lower direct and indirect costs.

Cell Encapsulating Biomaterial Regulates Mesenchymal Stromal/Stem Cell Differentiation and Macrophage Immunophenotype

“…Inclusion of localized growth factor concentrations and matrix metalloproteinase (MMP) cleavable peptide sequences within the biomaterial can also stimulate angiogenesis or MSC differentiation within the construct and promote tissue regeneration [42,43]. Type I collagen is an ECM component commonly used for MSC encapsulation because of its low toxicity, weak immunogenicity, and favorable tissue remodeling properties.…”

Radiological and histopathological comparison of microporous polysaccharide hemospheres and oxidized regenerated cellulose in the rabbit brain: a study of efficacy and safety

“…in neurosurgical interventions are strong hemostatic efficacy, absence of tissue reaction or inflammation, bio-degradation capability, promotion of tissue healing, cost-effectiveness, minimal imaging artifacts and user-friendly handling (2,18). Non-absorbed hemostatic materials may result in foreign body reaction, edema and thus may provide a focus for infections (4,9).…”

“…Residual foreign material within the surgical field is an undesirable situation in neurosurgical interventions. Minimal use of hemostatic agent for effective hemostasis and maximal cleaning of field from residual agents after achievement of hemostasis is recommended (18). The in-vitro antimicrobial activity of ORC in the early post-operative period via decreasing the local pH has been shown previously (15), but ORC may also cause granulation formation without bio-degradation in the late post-operative period and this may result complicate the radiological and clinical differential diagnosis of abscess, residual/recurrent tumors and granuloma (10,12,13,16).…”

Effects of Ankaferd BloodStopper on dermal healing in diabetic rats

“…Many studies have investigated the healing potential of particular agents in animal models of diabetes, examining clinical effects or histological outcomes (24)(25)(26)(27). ABS has been used as a local haemostatic agent in surgery, but it was also shown to promote healing (5,9).…”