Newer Hemostatic Agents Used in the Practice of Dermatologic Surgery

Abstract

Minor postoperative bleeding is the most common complication of cutaneous surgery. Because of the commonality of this complication, hemostasis is an important concept to address when considering dermatologic procedures. Patients that have a bleeding diathesis, an inherited/acquired coagulopathy, or who are on anticoagulant/antiplatelet medications pose a greater risk for bleeding complications during the postoperative period. Knowledge of these conditions preoperatively is of the utmost importance, allowing for proper preparation and prevention. Also, it is important to be aware of the various hemostatic modalities available, including electrocoagulation, which is among the most effective and widely used techniques. Prompt recognition of hematoma formation and knowledge of postoperative wound care can prevent further complications such as wound dehiscence, infection, or skin-graft necrosis, minimizing poor outcomes.

Topical Brimonidine Gel as a Hemostatic Agent After Dermatologic Surgery

“…1 Depending on the severity of the bleed, treatment may range from simply applying pressure to reopening the wound to identify and ligate the culprit vessel(s). Bleeding can result in hematoma formation, increased risk of infection, and wound dehiscence.…”

“…1 Many methods of achieving hemostasis have been described, but despite surgeons' best techniques, mild bleeding can still occur after patients leave the office. 1 Many methods of achieving hemostasis have been described, but despite surgeons' best techniques, mild bleeding can still occur after patients leave the office.…”

Biopsy techniques for skin disease and skin cancer: A new approach

“…[ 4 ] Applying pressure, Gelfoam bandages, or simple stitching with nonabsorbable suture can be used for hemostasis. [ 5 ]…”

First Safety and Performance Evaluation of T45K, a Self-Assembling Peptide Barrier Hemostatic Device, After Skin Lesion Excision

“… 2 Although not life-threatening, it can predispose the patient to hematoma formation, increased risk of infection, skin graft necrosis, and wound dehiscence. 3 , 4 Bleeding complications potentially interfere with the surgical outcome and may extend the duration of wound treatment. 2 …”

“…Dermatologic surgeons may operate on patients without stopping the medications perioperatively because the benefit of these therapeutic agents often outweighs the risk of bleeding complications. 3 , 5 …”