Topical hemostatic agents in spinal surgery
Spinal surgery can be associated with significant intraoperative blood loss which may lead to various complications. As the number of patients undergoing spinal surgery increases over time, accurate and effective hemostasis becomes critically important. Despite various surgical hemostatic techniques...
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| Published in | The spine journal Vol. 24; no. 6; pp. 933 - 946 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.06.2024
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| Subjects | |
| Online Access | Get full text |
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| Abstract | Spinal surgery can be associated with significant intraoperative blood loss which may lead to various complications. As the number of patients undergoing spinal surgery increases over time, accurate and effective hemostasis becomes critically important. Despite various surgical hemostatic techniques, conventional interventions such as compression, suture, ligation, and heat-generating cautery, are not suitable for osseous and epidural venous plexus bleeding during spinal procedures. Therefore, a variety of hemostatic agents have been developed to promote hemostasis. As they differ in terms of mechanism, form, application and potential adverse reactions, it is important to understand the natural features of existing agents. Here we comprehensively review currently available topical hemostatic agents from different sources and summarize their mechanisms of action, applications, and current or potential utilization in spinal surgery. We found hemostatic agents from different sources exert hemostatic actions through different mechanisms. In addition, topical hemostatic agents play various roles in spinal surgery including as hemostatic agent, dura mater repair, drug-carrier, skin closure, and fibrosis prevention. Compressive neurological complications are the most common complications of these hemostatic agents. Therefore, optimal use in spinal environments should match their features, indications, and efficacy with clinical conditions. |
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| AbstractList | Spinal surgery can be associated with significant intraoperative blood loss which may lead to various complications. As the number of patients undergoing spinal surgery increases over time, accurate and effective hemostasis becomes critically important. Despite various surgical hemostatic techniques, conventional interventions such as compression, suture, ligation, and heat-generating cautery, are not suitable for osseous and epidural venous plexus bleeding during spinal procedures. Therefore, a variety of hemostatic agents have been developed to promote hemostasis. As they differ in terms of mechanism, form, application and potential adverse reactions, it is important to understand the natural features of existing agents. Here we comprehensively review currently available topical hemostatic agents from different sources and summarize their mechanisms of action, applications, and current or potential utilization in spinal surgery. We found hemostatic agents from different sources exert hemostatic actions through different mechanisms. In addition, topical hemostatic agents play various roles in spinal surgery including as hemostatic agent, dura mater repair, drug-carrier, skin closure, and fibrosis prevention. Compressive neurological complications are the most common complications of these hemostatic agents. Therefore, optimal use in spinal environments should match their features, indications, and efficacy with clinical conditions. |
| Author | Shen, Feng Li, Yanhui Wang, Ting Wang, Yuelei Yin, Chuqiang Ding, Jian Han, Zengshuai Ren, Xianfeng |
| Author_xml | – sequence: 1 givenname: Feng orcidid: 0000-0002-2261-8667 surname: Shen fullname: Shen, Feng organization: Department of Spine Surgery, Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Shinan District, Qingdao, Shandong Province, China – sequence: 2 givenname: Jian surname: Ding fullname: Ding, Jian organization: Department of Spine Surgery, Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Shinan District, Qingdao, Shandong Province, China – sequence: 3 givenname: Yuelei surname: Wang fullname: Wang, Yuelei organization: Department of Spine Surgery, Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Shinan District, Qingdao, Shandong Province, China – sequence: 4 givenname: Chuqiang surname: Yin fullname: Yin, Chuqiang organization: Department of Spine Surgery, Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Shinan District, Qingdao, Shandong Province, China – sequence: 5 givenname: Zengshuai surname: Han fullname: Han, Zengshuai organization: Department of Spine Surgery, Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Shinan District, Qingdao, Shandong Province, China – sequence: 6 givenname: Xianfeng surname: Ren fullname: Ren, Xianfeng organization: Department of Spine Surgery, Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Shinan District, Qingdao, Shandong Province, China – sequence: 7 givenname: Yanhui surname: Li fullname: Li, Yanhui organization: School of Mechanical and Electrical Engineering, Qingdao University, No. 308 Ningxia Road, Shibei District, Qingdao, Shandong Province, China – sequence: 8 givenname: Ting surname: Wang fullname: Wang, Ting email: wangting20@hotmail.com organization: Department of Spine Surgery, Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Shinan District, Qingdao, Shandong Province, China |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38219838$$D View this record in MEDLINE/PubMed |
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| Keywords | Commercial products Mechanism of action Topical hemostatic agents Application Spine surgery mechanism of action spine surgery topical hemostatic agents application commercial products |
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