Table 3.
Commercially available polymer-based hemostatic systems.
| Name [Ref.] | Polymeric System | Form of Application | Hemostatic Efficacy (Based on Clinical Trials) | Reported Drawbacks |
|---|---|---|---|---|
| GelFoam®® [41] | Gelatin | Compressed sponge | Capable of absorbing up to 45 times its weight of whole blood. Hemostatic success in 10 min. | Abscess formation, breathing difficulties, fluid encapsulation. |
| Tachosil®® [154] | Equine collagen | Two-layer patch/sponge material with equine collagen on one side and fibrinogen-thrombin on the other side. | Hemostasis achieved in 3 min. | Hypertension, increased transaminases. |
| Surgicel®® [154,155] | Cellulose (ORC) |
Loose knit absorbable powder | Hemostatic success in 5 min. | Foreign body reactions, tissue necrosis, nerve damage. |
| Traumastem®® [156] | Cellulose (ONRC) |
Fibrous re-absorbable dressing | Hemostatic success in 10 min. | No adverse reactions reported. |
| InStat®®, HeliStat®® [154,157] | Bovine collagen | Dry absorbent hemostatic agent in microfibrillar form. | Hemostatic success in 5 min. Left in place, reabsorbed within 8 to 10 weeks. |
Swelling and allergic reactions. |
| FloSeal®® [154,158] | Gelatin | Adjunct hemostat–collagen granules dispersed in human thrombin (syringe application). | Hemostatic success within 10 min. Forms mechanically stable clot. Reabsorbed within 8 to 10 weeks. | Rare reports of inflammatory responses. |
| Celox Rapid®® [11] Duraseal®® [154] TissuGlu®® [159] Tegaderm®® [160] |
Polyurethane Chitosan Polyurethane PEG |
Adhesive mesh. Hemostatic gauze. Adhesive sterile dressing. Absorbable hydrogel delivered by a dual-syringe applicator. |
Adhesive crosslinking takes place in 30 to 40 min, allowing surgeons to reapproximate skin layer before the adhesive sets in. Can eliminate the need of post-surgical drains. Stops bleeding within one minute of compression. Stops bleeding within one minute of compression. Crosslinks immediately and creates watertight closure within 5 min. |
Seroma formation, hematoma, immunological reactions, wound separation. Embolism, pain. Embolism. Pain. Renal compromise, inflammatory reactions, delayed healing. |