Review of Therapeutics
An Essential Primer for Understanding the Role of Topical Hemostats, Surgical Sealants, and Adhesives for Maintaining Hemostasis
Article first published online: 17 MAY 2013
© 2013 Pharmacotherapy Publications, Inc.
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
Volume 33, Issue 9, pages 935–955, September 2013
How to Cite
(Pharmacotherapy 2013;33(9):935–955) doi: 10.1002/phar.1291)
- Issue published online: 3 SEP 2013
- Article first published online: 17 MAY 2013
- ZymoGenetics, Inc
- topical hemostat;
- surgical bleeding;
- pharmacist's role;
- pharmacy and therapeutics committee
A wide variety of topical hemostats are approved as adjunctive therapies in the maintenance of hemostasis during surgical procedures in which conventional methods are insufficient or not practical. A multidisciplinary approach to the selection and application of these agents requires input from all members of the surgical team including surgeons, perioperative nurses, blood bank specialists, and pharmacists. However, pharmacist knowledge regarding topical hemostats may be limited based on lack of formal education within college of pharmacy curricula as well as their use being predominantly in the operating room setting. Furthermore, some of these agents might be procured through central supply rather than the hospital pharmacy. Topical hemostats include agents that act as a mechanical barrier to bleeding and provide a physical matrix for clotting, biologically active agents that catalyze coagulation, combination therapies, and synthetic sealants and adhesives. Although many of the topical hemostats were approved for use before the requirement for clinical trials, this review provides an overview of the available clinical evidence regarding the appropriate uses and safety considerations associated with these agents. Proper use of these agents is vital to achieving the best clinical outcomes. Specifically, knowledge of the contraindications and potential adverse events associated with topical hemostats can help prevent unwanted outcomes. Therefore, an understanding of the benefits and potential risks associated with these agents will allow hospital pharmacists to assist in the development and implementation of institutional policies regarding the safe and effective use of hemostatic agents commonly used in the surgical suite.