Table 1 Types and Indications of Surgical Haemostats and Tissue Sealants

Types

Oxidised cellulose (regenerated)

Collagens

Powders

Gelatin sponges

Polysaccharide spheres

Flowables (thrombin and gelatin)

Fibrin sealants

Advanced patches (with fibrin sealants or polyethylene glycol)

Fibrin based

Synthetic (i.e. cyanoacrylates or polyethylene glycol)

Semi-synthetic (i.e. glutaraldehyde–albumin)

Mode of action

Contact activation and platelet aggregation

   Relies on the patient’s ability to generate clotting factors

Functions independently of the patient’s ability to generate clotting factors

Functions independently of the patient’s ability to generate clotting factors

Bleeding range

Mild (capillary oozing) to moderate bleeding

Broad range of active bleeding

Pre-emptive for anticipated bleeding

Patient factors

Intact coagulation

   Limited effect in heparinised and/or anticoagulated treated patients

Compromised coagulation

   Effective in heparinised and/or anticoagulated treated patients

Compromised coagulation

   Effective in heparinised and/or anticoagulated treated patients