title: Hemostasis in endoscopic sinus surgery using a specific gelatin-thrombin based agent (FloSeal).
abstract: The safety and efficacy of a new hemostatic sealant, based on a gel with collagen derived particles and topical thrombin (FloSeal, Fusion Medical Technologies, Inc. Fremont, CA) were assessed as an alternative to nasal packing for hemostasis in functional endoscopic sinus surgery. In a prospective clinical study of 50 patients undergoing bilateral endoscopic anterior ethmoidectomy, 2 ml FloSeal was used after surgery to stop bleeding. The results were compared to a control group of 50 patients with Merocel packing and showed that intraoperative hemostasis was rapid and equal in both groups. The main advantages of the new hemostatic sealant included a higher degree of comfort during postoperative nasal breathing and absence of complaints due to pressure or pain. There was only one case of postoperative bleeding on the 6th day, which required nasal packing. There were no more cases of stenoses or synechia in the ostiomeatal complex than were found in the Merocel group. No systemic side effects due to FloSeal were observed. This specific hemostatic sealant was shown to be a safe and efficacious alternative method for hemostasis in endoscopic sinus surgery with high patient satisfaction and an easy and fast mode of application.
authors.affiliation: Department of ENT, Head and Neck Surgery, University Hospital, Inselspital, Berne, Switzerland.
authors.forename: Ariane
authors.initials: A
authors.lastname: Baumann
authors.forename: Marco
authors.initials: M
authors.lastname: Caversaccio
mesh_terms: D016063:Blood Loss, Surgical / Q000517:prevention & control; D004724:Endoscopy; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D006487:Hemostasis / Q000187:drug effects*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D015508:Nasal Obstruction / Q000517:prevention & control; D010256:Paranasal Sinuses / Q000601:surgery*; D017060:Patient Satisfaction; D011182:Postoperative Care; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; C411004:FloSeal Matrix; D006490:Hemostatics