Severe blood loss during spinal reconstructive procedures: the potential usefulness of topical hemostatic agents.

Abstract:

:Complex spinal reconstructive procedures are invariably associated with excessive intraoperative blood loss that significantly increases the risk of severe perioperative complications. In some cases, excessive hemorrhage is equivalent to estimated total blood volume. Unfortunately, widely exposed bony surfaces are not amenable to standard hemostatic maneuvers utilized during soft tissue surgery. This article evaluates the clinical effectiveness of several approaches to blood management in this setting, and hypothesizes that underappreciated topical hemostatic agents may provide benefit by reducing the need for autologous predonation, banked donor blood or antifibrinolytic agents. Topical agents combining collagen, thrombin and fibrin have demonstrated initial promise by inducing platelet aggregation and initiating the clotting cascade when applied directly to bleeding bony sites. Clinical studies are clearly warranted.

journal_name

Med Hypotheses

journal_title

Medical hypotheses

authors

Block JE

doi

10.1016/j.mehy.2005.02.012

keywords:

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

617-21

issue

3

eissn

0306-9877

issn

1532-2777

pii

S0306-9877(05)00106-4

journal_volume

65

pub_type

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