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Evolution of hemostatic agents in surgical practice.
Chandru P Sundaram1, Alison C Keenan
1Department of Urology, Indiana University School of Medicine, Indianapolis.
Summary
Topical hemostatic agents, including fibrin sealants and collagen, have evolved significantly. Future research should focus on adapting these agents for minimally invasive urology procedures.
Area of Science:
- Surgical Innovation
- Biomaterials Science
- Medical Device Evolution
Background:
- Topical hemostatic agents are crucial in diverse surgical scenarios.
- Understanding their historical development is key to appreciating current applications.
Purpose of the Study:
- To review the historical progression of topical hemostats.
- To identify future research opportunities in surgical hemostasis.
Main Methods:
- A comprehensive MEDLINE literature search was conducted.
- Key hemostatic agent classes reviewed include fibrin sealants, gelatin sponge, cyanoacrylate adhesives, oxidized cellulose, and microfibrillar collagen.
Main Results:
- Hemostatic agents utilize diverse mechanisms for bleeding control.
- Fibrin sealants show significant potential for advancement.
- Other agents like gelatin sponge have seen limited evolution, while cyanoacrylates and collagen offer unique application opportunities.
Conclusions:
- The evolution of topical hemostats presents avenues for novel research.
- Fibrin sealants offer the most promising area for development.
- Adapting hemostatic agents for minimally invasive urology is a valuable future direction.
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