Histologic findings following use of hydrophilic polymer with potassium ferrate for hemostasis

Hydrophilic polymer with potassium salt is a hemostatic agent marketed for use by healthcare professionals and as an over-the-counter product available to healthcare consumers. In particular, dermatologic surgeons may use hydrophilic polymer for hemostasis in wounds left to heal by secondary intention. Foreign body reaction to hydrophilic polymer was recently reported. The microscopic findings in four additional patients treated with hydrophilic polymer are presented. The wounds of three patients were treated with hydrophilic polymer following a dermatologic surgical procedure while one patient used over-the-counter hydrophilic polymer on an abrasion. Three patients developed a foreign body reaction. Histopathologic examination revealed angulated fragments of deep purple material representing hydrophilic polymer admixed with round orange-red bodies and yellow-brown granules representing potassium ferrate. The components were found both free in the dermis and within multinucleated giant cells. Hydrophilic polymer must be differentiated from other materials observed in re-excision specimens, including ferric subsulfate, aluminum chloride and Gelfoam(®) (Pharmacia and Upjohn Co., New York, NY, USA).