Haemostasis in neurosurgery: What is the evidence for gelatin-thrombin matrix sealant?

• Published in: Journal of clinical neuroscience Vol. 20; no. 3; pp. 349 - 356
• Main Authors: Yao, Henry H.I, Hong, Matthew K.H, Drummond, Katharine J
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.03.2013
• Subjects: Animals; Cranial surgery; Floseal; Gelatin - therapeutic use; Gelatin Sponge, Absorbable - therapeutic use; Gelatin-thrombin matrix sealant; Haemostasis; Haemostatic agent; Hemostasis, Surgical - methods; Hemostatics - therapeutic use; Humans; Laparoscopy; Nervous system; Neurology; Neurosurgery; Neurosurgery - methods; Neurosurgical Procedures - methods; Spinal surgery; Surgery; Thrombin - therapeutic use; Gelatin-thrombin matrix sealant; Haemostasis; Spinal surgery; Cranial surgery; Floseal; Haemostatic agent
• ISSN: 0967-5868; 1532-2653
• DOI: 10.1016/j.jocn.2012.09.005

Abstract Strict intra-operative haemostasis is essential in the practice of neurosurgery. Over the last century, haemostatic methods have advanced significantly and the modern surgeon is now faced with an array of haemostatic agents, each with subtly different qualities and proven in different contexts with various levels of evidence. The popularity of endoscopic and laparoscopic procedures in other surgical specialties has encouraged the introduction of novel agents to achieve haemostasis where conventional methods have proven difficult. These agents are beginning to find a role in routine use for surgery in both the elective and emergent settings. This article reviews the mechanisms of different haemostasis methods and the current evidence for their use in neurosurgery, with a focus on the more recently introduced gelatin-thrombin matrix sealant (Floseal® [Baxter, Hayward, CA, USA]).