The use of local agents: bone wax, gelatin, collagen, oxidized cellulose

Abstract

The use of local agents to achieve hemostasis is an old and complex subject in surgery. Their use is almost mandatory in spinal surgery. The development of new materials in chemical hemostasis is a continuous process that may potentially lead the surgeon to confusion. Moreover, the more commonly used materials have not changed in about 50 years. Using chemical agents to tamponade a hemorrhage is not free of risks. Complications are around the corner and can be due either to mechanical compression or to phlogistic effects secondary to the material used. This paper reviews about 20 animal and clinical published studies with regard to the chemical properties, mechanisms of action, use and complications of local agents.

Preparation of reduced graphene oxide/gelatin composite films with reinforced mechanical strength

“…For example, gelatin is the most important and dominant material in medicinal capsules [32,33], although cellulose and other non-gelatin capsules have recently emerged [34]. Gelatin sponges are used as hemostatic materials [35,36] in surgery and antiadhesion materials [37,38] to prevent postoperative adhesion. Gelatin films can be used as edible packaging films [39,40], nutritional membranes [41,42] and biomaterials [43][44][45].…”

Synthesis and Characterization of Reduced Graphene Oxide/Gelatin Composite Films

“…6 However, high hygroscopicity and low strength in the wet state significantly hinder gelatin in biomedical and engineering applications. Thus, modification of gelatin has always been an issue of great interest.…”

Processing, characterization and hemostatic mechanism of a ultraporous collagen/ORC biodegradable composite with excellent biological effectiveness

“…3 Numerous tamponade hemostatic materials, such as gelatin sponges, chitin, and chitosan sponges, were introduced in surgery, and had both advantages and limitations. 4,5 For instance, due to its softness and insufficient pressure on the wound, gelatin sponge has a relatively long hemostatic time, with no anti-inflammatory effects to prevent infection of the alveolar socket. 6,7 Also, its biodegradability makes it unsuitable for long-term implantation in vivo.…”

“…[25][26][27] Meanwhile, ORC cannot adhere to surgical instruments, since it is made from natural materials. 4,28 In polymer science, a composite material could possess different advantages from its component polymers, arising from its interfacial properties. 29,30 At the same time, the hemostatic properties, biodegradable properties, and biological safety performance concurrently play a decisive role in oral and maxillofacial surgery, especially for operations which require the implantation of biodegradable hemostatic materials.…”