The use of local agents: bone wax, gelatin, collagen, oxidized cellulose.
The use of local agents to achieve hemostasis is an old and complex subject in surgery. Their use is almost mandatory in spinal surgery. The development of new materials in chemical hemostasis is a continuous process that may potentially lead the surgeon to confusion. Moreover, the more commonly used materials have not changed in about 50 years. Using chemical agents to tamponade a hemorrhage is not free of risks. Complications are around the corner and can be due either to mechanical compression or to phlogistic effects secondary to the material used. This paper reviews about 20 animal and clinical published studies with regard to the chemical properties, mechanisms of action, use and complications of local agents.
Schonauer
Claudio
C
Department of Neurosciences, Second University of Naples, Naples, Italy. cschona@libero.it.
Tessitore
Enrico
E
Barbagallo
Giuseppe
G
Albanese
Vincenzo
V
Moraci
Aldo
A
D000287:Administration, Topical; D000818:Animals; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002483:Cellulose, Oxidized / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D003094:Collagen / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004338:Drug Combinations; D005780:Gelatin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006487:Hemostasis / Q000187:drug effects*; D006490:Hemostatics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D010168:Palmitates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013131:Spine / Q000601:surgery*; D014885:Waxes / Q000009:adverse effects / Q000627:therapeutic use; D014945:Wound Healing / Q000187:drug effects*
D002483:Cellulose, Oxidized; D004338:Drug Combinations; D006490:Hemostatics; D010168:Palmitates; D014885:Waxes; C055480:bone wax; D005780:Gelatin; D003094:Collagen