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Updated: May 9, 2026
14:58
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Intraoperative Agents for Hemostasis and Dural Reconstruction in Neurosurgery
Youssef E Sibih1, Alexander F Haddad1, David J Caldwell1
1Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
Neurosurgery Practice
|May 8, 2026
Summary
Neurosurgeons need to understand hemostatic agents and dural sealants beyond surgeon preference. This review compares products by composition, action, and limitations for better intraoperative decision-making.
Area of Science:
- Neurosurgery
- Biomaterials Science
- Surgical Technology
Background:
- Intraoperative hemostasis and dural closure are vital in neurosurgery, impacting patient outcomes and complication risks.
- Product selection for these critical steps often relies on preference rather than evidence-based understanding of material properties.
Purpose of the Study:
- To provide a neurosurgery-focused comparison of hemostatic agents, dural substitutes, and sealants.
- To detail product composition, mechanism of action, indications, benefits, drawbacks, safety, and cost.
Main Methods:
- Qualitative literature review using PubMed, Embase, FDA data, and manufacturer information.
- Categorization of products into hemostatic adjuncts, dural substitutes/grafts, and liquid sealants/adhesives.
Main Results:
- The review covers gelatin, oxidized regenerated cellulose, collagen, gelatin-thrombin, thrombin, autologous/nonautologous grafts, and fibrin/polyethylene glycol sealants.
- Emphasis on product-specific limitations and safety considerations.
Conclusions:
- Informed selection of hemostatic and dural closure products requires considering anatomy, patient factors, and evidence.
- This review acts as a practical guide for neurosurgical decision-making.
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