Use of Gelatin-Thrombin Matrix Hemostatic Sealant in Cranial Neurosurgery

Abstract

The present study evaluated the hemostatic efficacy and handling of gelatin-thrombin matrix hemostatic sealant during intracranial procedures. A retrospective analysis of 478 consecutive patients undergoing intracranial procedures identified seven patients with acute intense or persistent intraoperative bleeding which could not be arrested in time by standard hemostatic methods. The efficacy of gelatinthrombin matrix was assessed by determining bleeding severity before and after application, time to hemostasis, amount of gelatin-thrombin matrix necessary, need for additional hemostatic measures, and need for reoperation to control hemorrhage. Immediate hemostasis was achieved in five of seven patients. Two of these five patients had abnormal clotting parameters. Cessation of bleeding was achieved by additionally applying either fibrinogen or gelatin sponge to the bleeding site in the other two patients. No complications attributable to gelatin-thrombin matrix use were recorded. The gelatinthrombin matrix was ready to use within 1 minute in every case. Gelatin-thrombin matrix appears to be an effective, easy-to-use, and readily available hemostatic agent for cranial neurosurgery. Combination with fibrinogen is recommended in special situations.

The use of novel hemostatic sealant (Tisseel®) in laparoscopic myomectomy: a case–control study

“…Hemostatic agents and tissue sealants are used routinely to prevent excess blood loss and for reconstruction during surgical repair [14][15][16][17][18]38]. Several studies have been conducted to evaluate the hemostatic effect of these agents [39][40][41].…”

“…Recently, a lot of hemostatic agents and tissue sealants have been used with the goal to prevent excess blood loss and for reconstruction during surgical repair [13][14][15][16][17][18]. Several studies have evaluated the efficacy of these agents.…”

Reducing blood loss at myomectomy with use of a gelatin-thrombin matrix hemostatic sealant

“…Hemostatic agents and tissue sealants are used routinely to prevent excess blood loss and in reconstruction during surgical repair (4)(5)(6)(7)(8)(9). FloSeal, a novel hemostatic sealant composed of thrombin and a gelatin matrix, has become commercially available since it was approved by the US Food and Drug Administration in 1999 (4)(5)(6)(7)(8)(9).…”

“…This effect is supported by the moderate swelling (about 10%-20%) of the gelatin-thrombin matrix after contact with blood or other body fluids. This gelatin-thrombin matrix is useful in cardiac (4), spinal (5), maxillofacial and plastic facial (6), rhinologic (7), brain (8), and urologic (9) surgery. However, little is known about its use in gynecologic surgery.…”

Securing Hemostasis in Pediatric Low-Grade Posterior Cerebral Fossa Tumors: The Value of Thrombin-Gelatin Hemostatic Matrix

“…The use of TGHM, as a complementary tool for obtaining hemostasis, is broadly described in neurosurgical fields, especially in endoscopic endonasal approaches [4-8] and also in cranial and spinal surgery [9-15]. Furthermore, the safety, biocompatibility, and economic value of this product are well established [1, 10, 16].…”