A Comprehensive Review of Topical Hemostatic Agents

In Brief Since ancient times we have attempted to facilitate hemostasis by application of topical agents. In the last decade, the number of different effective hemostatic agents has increased drastically. In order for the modern surgeon to successfully choose the right agent at the right time, it is essential to understand the mechanism of action, efficacy and possible adverse events as they relate to each agent. In this article we provide a comprehensive review of the most commonly used hemostatic agents, subcategorized as physical agents, absorbable agents, biologic agents, and synthetic agents. We also evaluate novel hemostatic dressings and their application in the current era. Furthermore, wholesale acquisition prices for hospitals in the United States are provided to aid in cost analysis. We conclude with an expert opinion on which agent to use under different scenarios. Advances in biotechnology in the last 10 years have resulted in an explosive growth of topical hemostatic agents that are available to the modern surgeon. In this article we review the mechanism of action, advantage, and disadvantage of the most commonly used topical hemostatic agents in the United States.