Article: Comparison of Hemostatic Agents used in Vascular Surgery

Surgiflo

• Sterile and absorbable hemostatic porcine gelatin matrix that is mixed with thrombin JMI (a protein substance produced through the interaction of thrombin of bovine origin and calcium chloride).

FloSeal

• Bovine gelatin matrix, calcium chroride and plasma derived human thrombin
• Gelatin granules absorb blood and swell (20% within 10min).
• React with patients fibrinogen to form a stable clot which reabsorbs within 6-8 weeks.

Avitene

• Bovine microfibrillar collagen sponge
• Collagen hemostats are derived from bovine skin
• Bind tightly to blood surfaces to provide a matrix for clot formation and strengthening, as well as enhancement of platelet aggregation, degranulation and release of clotting factors, thus further promoting clot formation
• Water soluble
• Thrombin ineffective due to pH factors
• Absorbs in 8-10 weeks
• Complications include swelling and allergic reaction

Gelfoam/Surgifoam

• Gelatin is a hydrocolloid made from acid partial hydrolysis of porcine-derived collagen that is whipped into foam and then dried
• Gelatin absorbs blood up to 40x its weight and expands to 200% of its initial dimensions
• Absorbs after 4-6 weeks

Surgicel

• Oxidized regenerated cellulose that originates from degenerating wood pulp
• Thrombin ineffective due to pH factors
• Can absorb 7-10 times its own weight
• Act on instrinsic pathway causing contact activation and platelet activation, aiding in clot formation
• Absorbed within 4-8 weeks
• When metabolized, oxidized methylcellulose imparts a surrounding fluid pH of 2.8. Although direct mechanical trauma may always be a cause of neural dysfunction, the acid pH of the oxidized methylcellulose breakdown environment may be the most likely factor of neural dysfunction when used in the mandibular third molar extraction socket.

Hemostatic Agents