Local and Systemic Hemostatic Agents: A Comprehensive Review

Traumatic hemorrhage is the leading preventable cause of death worldwide. Systemic administration of hemostatic agents requires trained personnel and preparation, limiting their use in combat environments and prehospital settings. However, local administration of hemostatic agents may ameliorate these challenges. Currently available hemostatic products are limited by risk of infection, immunogenicity, tissue damage, limited usage and efficacy, high costs, short shelf life, and storage requirements under specific conditions. Future studies should be considered to overcome these limitations and develop effective, multifunctional hemostatic materials for widespread usage. In this review, we will provide an overview of the most commonly used systemic and local hemostatic agents in hemorrhage control.