Neurosurgery notes/Pharmacology/Anti-platelet-coagulation/Coagulation methods/Surgical hemostatic

Surgical hemostatic

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Coagulation methods

Arista™ AH

  • Is a 100% plant based absorbable surgical hemostatic powder derived from purified plant starch
  • No mixing and no refrigeration
  • Ready on demand
  • Thrombin free, biocompatible and non-pyrogenic
  • Typically absorbed in 24-48 hours* by amylases

TachoSil

  • Human thrombin and fibrinogen with equine collagen
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Hemopatch®

  • Thin, pliable collagen pad with high liquid absorption capacity, coated with a protein-reactive polyethylene glycol monomer (pentaerythritol polyethylene glycol ether tetra-succinimidyl glutarate, NHS-PEG).
  • Covalent binding to proteins via the NHS-PEG coating induces the formation of a hydrogel that allows rapid adhesion to the target site, where the patch forms a liquid-tight barrier. The collagen matrix also promotes blood clotting
  • Used for
    • CSF leak sealing
    • Haemostasis
  • Not to be used
    • Hypersensitivity to bovine proteins or brilliant blue,
    • Intraoperative pulsatile or severe bleeding
    • Infection at the target application site (TAS)
  • Time to haemostasis 2mins
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Summary

Hemostat
Notes
Surgicel (Johnson & Johnson)
Oxidized cellulose
Floseal (Baxter)
Human‑derived thrombin with bovine‑derived gelatin matrix granules that are mixed at the time of use
Surgiflo (Johnson & Johnson)
Porcine gelatin
Spongostan (Johnson & Johnson)
Porcine gelatin
Hydrogen peroxide
Vasoconstrictive; disrupts the blood–barrier causing aggregation of platelets and neutrophils leading to thrombus formation; free diffusion of H₂O₂ through vessel walls and its conversion to water and O₂ can create intraluminal bubbles, microembolisms, and vessel obstruction
TachoSil (Takeda); Tisseel (Baxter International); Evicel (Ethicon, Johnson & Johnson)
Fibrin glues containing thrombin and fibrinogen in separate chambers; when combined, fibrinogen is activated by thrombin and converted to fibrin monomer, which interacts with patient factor VIII and calcium to form a fibrin polymer that supports platelet activation and hemostasis
Avitene (Davol)
Microfibrillar collagen
Arista (Medafor)
Potato starch