title: Hemostats, sealants, and adhesives: a practical guide for the surgeon.
abstract: Hemostats, sealants, and adhesives are useful adjuncts to modern surgical procedures. To maximize their benefit, a surgeon needs to understand the safety, efficacy, usability, and cost of these agents. To be truly added to a surgeon's own toolbox, the operator must also have knowledge  of when and how to best use these materials. This commentary is designed to succinctly facilitate this understanding and knowledge. A nomenclature and classification system based on group, category, and class has been created to help with this process and is provided here. By using this system,  materials consisting of similar design and for common indications can be compared. For example, in this system, the three functional groups are hemostats, sealants, and adhesives. The hemostats may be divided into four categories: mechanical, active, flowable, and fibrin sealant. These hemostat  categories are further subdivided into generic classes based on the composition of the approved materials. Similarly, categories and classes are provided for sealants and adhesives. In this commentary, the salient points with respect to the characteristics of these agents are presented. A  discussion of when these agents can be used in specific indications and how they may be applied to achieve the best results is also provided.
authors.affiliation: Surgical Therapeutic Advancement Center, Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, USA. wspotnitz@virginia.edu
authors.forename: William D
authors.initials: WD
authors.lastname: Spotnitz
mesh_terms: D005260:Female; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology / Q000627:therapeutic use*; D006490:Hemostatics / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008422:Materials Testing; D017410:Practice Guidelines as Topic; D017751:Safety Management; D013514:Surgical Procedures, Operative / Q000379:methods*; D014014:Tissue Adhesives / Q000494:pharmacology / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D006490:Hemostatics; D014014:Tissue Adhesives