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:: Volume 18, Issue 4 (Winter 2021) ::
Sci J Iran Blood Transfus Organ 2021, 18(4): 291-312 Back to browse issues page
A Review of Hemostatic Agents and Products
A. Ansari , F. Khosronezhad, Y. Shallageh, A. Zare, Sh. Afaghi saray, M. Hasanzadeh
Keywords: Key words: Hemostatics, Blood Coagulation Factors, Dressings, Trauma
Full-Text [PDF 739 kb]   (667 Downloads)     |   Abstract (HTML)  (1550 Views)
Type of Study: Review Article | Subject: Hematology
Published: 2021/12/31
Full-Text:   (5108 Views)
  1. Pogorielov M V, Sikora VZ. Chitosan as a Hemostatic Agent: Current State. Eur J Med Ser B 2015; 1(1): 24-33.
  2. Alam HB, Burris D, DaCorta JA, Rhee P. Hemorrhage control in the battlefield: role of new hemostatic agents. Mil Med 2005; 170(1): 63-9.
  3. Liu J, Lan G, Lu B, He L, Yu K, Chen J, et al. Properties of a new hemostatic gauze prepared with in situ thrombin induction. Biomed Phys Eng Express 2017; 3: 015001.
  4. Nakielski P. Investigation of blood clotting mechanism in contact with nanofibers. Funding agency: National Science Centre (NCN); 2016. Available from: http://www.nanoprg.com/blood-clotting-nanofibers.
  5. Kalalinia F, Amiri N, Mehrvarzian N, Fazly Bazzaz BS, Iranshahi M, Shahroodi A, et al. Topical green tea formulation with anti-hemorrhagic and antibacterial effects. Iran J Basic Med Sci 2020; 23(8): 1085-90.
  6. Brown TM, Fee E. Henry E. Sigerist: medical historian and social visionary. Am J Public Health 2003; 93(1): 60.
  7. Aris A. Hemostatic herbs. Ann Thorac Surg 2002; 74(4): 1291.
  8. Alipour H, Koosha M, Sarraf Shirazi MJ. Modern Commercial Wound Dressings and Introducing New Wound Dressings for Wound Healing: A Review. Basparesh 2016; 6(4): 65-80.
  9. Hassiba AJ, El Zowalaty ME, Nasrallah GK, Webster TJ, Luyt AS, Abdullah AM, et al. Review of recent research on biomedical applications of electrospun polymer nanofibers for improved wound healing. Nanomedicine 2016; 11(6): 715-37.
  10. Zahedi P, Rezaeian I, Ranaei-Siadat SO, Jafari SH, Supaphol P. A review on wound dressings with an emphasis on electrospun nanofibrous polymeric bandages. Polym Adv Technol 2010; 21(2): 77-95.
  11. Shah A, Palmer AJR, Klein AA. Strategies to minimize intraoperative blood loss during major surgery. Br J Surg 2020; 107(2): 26-38.
  12. Ghosh S, Tripathi A, Gayen P, Sinha Roy R. Peptide-based topical agents and intravenous hemostat for rapid hemostasis. RSC Med Chem 2020; 11(10): 1100-11.
  13. Chiara O, Cimbanassi S, Bellanova G, Chiarugi M, Mingoli A, Olivero G, et al. A systematic review on the use of topical hemostats in trauma and emergency surgery. BMC Surg 2018; 18(68): 1-20.
  14. Hadjizadeh A, Doillon CJ. Directional migration of endothelial cells towards angiogenesis using polymer fibres in a 3D co-culture system. J Tissue Eng Regen Med 2010; 4(7): 524-31.
  15. Bohl Masters KS, Leibovich SJ, Belem P, West JL, Poole-Warren LA. Effects of nitric oxide releasing poly(vinyl alcohol) hydrogel dressings on dermal wound  healing in diabetic mice. Wound Repair Regen 2002; 10(5): 286-94.
  16. Zhong Y, Hu H, Min N, Wei Y, Li X LX. Application and outlook of topical hemostatic materials: a narrative review. Ann Transl Med 2021; 9(7): 577.
  17. Mikhail C, Pennington Z, Arnold PM, Brodke DS, Chapman JR CN. Minimizing Blood Loss in Spine Surgery. Glob Spine J 2020; 10(1): 71-83. Anne M Stachowicz JLW. Topical Hemostatic Agents in Gynecologic Surgery for Benign Indications. Obs Gynecol 2020; 135(2): 463-8.
  18. Rachel M Cullifer, Gretchen Makai, Michelle Pacis TH. Topical hemostatic and tissue-sealing agents in gynecologic surgery. Curr Opin Obs Gynecol 2020; 32(4): 285-91.
  19. Haram Kang SHH. Does topical application of tranexamic acid reduce intraoperative bleeding in sinus surgery during general anesthesia? Braz J Otorhinolaryngol 2020; 86(1): 111-8.
  20. Number 812. Topical Hemostatic Agents at Time of Obstetric and Gynecologic Surgery: ACOG Committee Opinion. Obs Gynecol 2020; 136(4): 81-9.
  21. Guyton AC. Guyton Physiology: Textbook of Medical Physiology. 20th ed. USA: Saunders; 2011. p. 1112.
  22. Chan KYT, Yong ASM, Wang X, Ringgold KM, St John AE, Baylis JR, et al. The adhesion of clots in wounds contributes to hemostasis and can be enhanced by coagulation factor XIII. Sci Rep 2020; 10(1): 20116.
  23. Versteeg HH, Heemskerk JW, Levi M RP. New fundamentals in hemostasis. Physiol Rev 2013; 93(1): 327-58.
  24. Hamrang A, Howell BA. Foundations of High Performance Polymers: Properties, Performance and Applications. Philadelphia: Taylor & Francis; 2013. p. 271.
  25. Kheirabadi B. Evaluation of topical hemostatic agents for combat wound treatment. US Army Med Dep J 2011; 25-37.
  26. Peralta MR CP. The use of new procoagulants in blunt and penetrating trauma. Curr Opin Anaesthesiol 2019; 32(2): 200-5.
  27. Gegel BT, Austin PN, Johnson AD. An evidence-based review of the use of a combat gauze (QuikClot) for hemorrhage control. AANA J 2013; 81(6): 453-8.
  28. Rhee P, Brown C, Martin M, Salim A, Plurad D, Green D, et al. QuikClot use in trauma for hemorrhage control: case series of 103 documented uses. J Trauma 2008; 64(4): 1093-9.
  29. Choron RL, Hazelton JP, Hunter K, Capano-Wehrle L, Gaughan J, Chovanes J, et al. Intra-abdominal packing with laparotomy pads and QuikClotTM during damage control laparotomy: A safety analysis. Injury 2017; 48(1): 158-64.
  30. Bennett BL, Littlejohn LF, Kheirabadi BS, Butler FK, Kotwal RS, Dubick MA, et al. Management of External Hemorrhage in Tactical Combat Casualty Care: Chitosan-Based Hemostatic Gauze Dressings--TCCC Guidelines-Change 13-05.  J Spec  Oper  Med    2014; 14(3): 40-57.
  31. Kheirabadi BS, Edens JW, Terrazas IB, Estep JS, Klemcke HG, Dubick MA, et al. Comparison of New Hemostatic Granules / Powders With Currently Deployed Hemostatic Products in a Lethal Model of Extremity Arterial Hemorrhage in Swine. J Trauma 2009; 66(2): 316-26.
  32. Parren D, Tomori T, Delima MG, Teranishi K, Carr W, Mcnamee G, et al. Comparison of 10 Hemostatic Dressings in a Groin transection model in swine. J Trauma 2009; 67(4): 848-55.
  33. Kheirabadi  BS,  Scherer  MR,  Estep JS, Dubick MA, Holcomb JB. Determination of Efficacy of New Hemostatic Dressings in a Model of Extremity Arterial Hemorrhage in Swine. J Trauma 2009; 67(3): 450-9. 
  34. Schauer SG, April MD, Naylor JF, Fisher AD, Cunningham CW, Ryan KL, et al. QuikClot ® Combat Gauze ® Use by Ground Forces in Afghanistan The Prehospital Trauma Registry Experience. J Spec Oper Med 2017; 17(2): 101-6.
  35. Shand S, Curtis K, Dinh M, Burns B. What is the impact of prehospital blood product administration for patients with catastrophic haemorrhage: an integrative review. Injury 2019; 50(2): 226-34.
  36. Rijnhout TWH, Wever KE, Marinus RHAR, Hoogerwerf N, Geeraedts LMG Jr, Tan ECTH. Is prehospital blood transfusion effective and safe in haemorrhagic trauma patients? A systematic review and meta-analysis. Injury 2019; 50(5): 1017-27.
  37. Johansson PI. Emerging treatment strategies for trauma-induced coagulopathy (Br J Surg 2012; 99(Suppl 1): 40-50). Br J Surg. 2012 Jan; 99 Suppl 1: 51.
  38. Sena MJ, Douglas G, Gerlach T, Grayson JK, Pichakron KO, Zierold D. A pilot study of the use of kaolin-impregnated gauze ( Combat Gauze ) for packing high-grade hepatic injuries in a hypothermic coagulopathic swine model. J Surg Res 2013; 183(2): 704-9.
  39. Causey MW, Mcvay DP, Miller S, Beekley A, Martin M. The efficacy of Combat Gauze in extreme physiologic conditions. J Surg Res 2012; 177(2): 301-5.
  40. Floyd CT, Rothwell SW, Risdahl J, Martin R, Olson C RN. Salmon thrombin-fibrinogen dressing allows greater survival and preserves distal blood flow compared to standard kaolin gauze in coagulopathic Swine with a standardized lethal femoral artery injury. J Spec Oper Med 2012; 12(2): 16-26.
  41. Kheirabadi BS, Mace JE, Terrazas IB, Fedyk CG, Valdez KK, MacPhee MJ, et al. Clot-Inducing Minerals Versus Plasma Protein Dressing for Topical Treatment of External Bleeding in the Presence of Coagulopathy. J Trauma 2010; 69(5): 1062-73.
  42. Spotnitz WD, Burks S. State-of-the-art review: Hemostats, sealants, and adhesives II: Update as well as how and when to use the components of the surgical toolbox. Clin Appl Thromb Hemost 2010; 16(5): 497-514.
  43. Barkun AN, Moosavi S, Martel M. Topical hemostatic agents: a systematic review with particular emphasis on endoscopic application in GI bleeding. Gastrointest Endosc 2013; 77(5): 692-700.
  44. Emilia  M,  Luca  S,  Francesca  B,   Luca  B, Paolo S, Giuseppe F, et al. Topical hemostatic agents in surgical practice. Transfus Apher Sci 2011; 45(3): 305-11.
  45. Howe  N,  Cherpelis  B.  Obtaining rapid and effective hemostasis: Part I. Update and review of topical hemostatic agents. J Am Acad Dermatol 2013; 69(5): 659.e1-659.e17.
  46. Holbert SE, Patel D, Rizk T, Dimitri NG JM. Intraoperative Anaphylaxis in Response to Hemostatic Agents With Protein Derivatives. Cureus 2020; 12(8): 9881.
  47. Allison J. Tompeck. A Comprehensive Review of Topical Hemostatic Agents: The Good, The Bad, and the Novel. J Trauma Acute Care Surg 2020; 88(1): 1-21.
  48. Lawson JH, Lynn KA, Vanmatre RM, Domzalski T, Klemp KF, Ortel TL, et al. Antihuman factor V antibodies after use of relatively pure bovine thrombin. Ann Thorac Surg 2005; 79(3): 1037-8.
  49. Schoenecker JG, Johnson RK, Lesher AP, Day JD, Love SD, Hoffman MR, et al. Exposure of Mice to Topical Bovine Thrombin Induces Systemic Autoimmunity. Am J Pathol 2001; 159(5): 1957–69.
  50. Chapman WC, Singla N, Genyk Y, Mcneil JW, Jr KLR, Reynolds TC, et al. A Phase 3 , Randomized , Double-Blind Comparative Study of the Efficacy and Safety of Topical Recombinant Human Thrombin and Bovine Thrombin in Surgical Hemostasis. J Am Coll Surg 2007; 205(2): 256-65.
  51. Centeno A, Rojas S, Arias B, Miquel I, Sánchez P, Ureta C, et al. A new topical hemostatic agent TT-173 reduces blood loss in a sheep model of total knee arthroplasty. Knee 2017; 24(6): 1454-61.
  52. Centeno A, Rojas S, Arias B, Miquel I, Sánchez P, Ureta C, et al. Experimental Evaluation of a New Tissue Factor-Based Topical Hemostat (TT-173) for Treatment of Hepatic Bleeding. J Invest Surg 2020; 33(4): 339-49.
  53. Belay ES, O’Donnell J, Flamant E, Hinton Z, Klifto CS AO. Intravenous tranexamic acid vs. topical thrombin in total shoulder arthroplasty: a comparative study. J Shoulder Elb Surg 2021; 30(2): 312-6.
  54. Alam HB, Chen Z, Jaskille A, Querol RI, Koustova E, Inocencio R, et al. Application of a Zeolite Hemostatic Agent Achieves 100 % Survival in a Lethal Model of Complex Groin Injury in Swine. J Trauma 2004; 56(5): 974-83.
  55. Bennett BL, Littlejohn L. Review of new topical hemostatic dressings for combat casualty care. Mil Med 2014; 179(5): 497-514.
  56. Arnaud F, Tomori T, Carr W, McKeague A, Teranishi K, Prusaczyk K, et al. Exothermic Reaction in Zeolite Hemostatic Dressings: QuickClot ACS and ACS+. Ann Biomed Eng 2008; 36(10): 1708-13.
  57. Lewis KM, Atlee H, Mannone A, Lin L, Goppelt A. Efficacy of hemostatic matrix and microporous polysaccharide hemospheres. J Surg Res 2015; 193(2): 825-30.
  58. Barnard J, Millner R, Cth F, Surgery C, Centre LC, Hospital BV, et al. A Review of Topical Hemostatic Agents   for  Use  in    Cardiac    Surgery.   ATS 2009; 88(4): 1377-83.
  59. Ferraris VA, Brown JR, Despotis GJ, Hammon JW, Reece TB, Saha SP, et al. 2011 Update to The Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists Blood Conservation Clinical Practice  Guidelines.  Ann   Thorac Surg 2011; 91(3): 944-82.
  60. Seyednejad H, Imani M, Jamieson T, Seifalian AM. Topical haemostatic agents. Br J Surg 2008; 95(10): 1197-225.
  61. Alam HB, Uy GB, Miller D, Koustova E, Hancock T, Inocencio R, et al. Comparative Analysis of Hemostatic Agents in a Swine Model of Lethal Groin Injury. J Trauma 2003; 54(6): 1077-82.
  62. Gegel BT, Burgert JM, Lockhart C, Austin R 3rd, Davila A, Deeds J, et al. Effects of Celox and TraumaDEX on hemorrhage control in a porcine model. AANA J 2010; 78(2): 115-20.
  63. Paternò VA, Bisin A, Addis A. Comparison of the efficacy of five standard topical hemostats: a study in porcine liver and spleen models of surgical bleeding. BMC Surg 2020; 20(1): 215.
  64. Samudrala S. Topical hemostatic agents in surgery: a surgeon's perspective. AORN J 2008; 88(3): S2-11.
  65. Morse DC, Silva E, Bartrom J, Young K, Bass EJ, Potter D, et al. Improved bleeding scores using Gelfoam Powder with incremental concentrations of bovine thrombin in a swine liver lesion model. J Thromb Thrombolysis 2016; 42(3): 352-9.
  66. Achneck HE, Sileshi B, Jamiolkowski RM, Shapiro ML, Lawson JH. A Comprehensive Review of Topical Hemostatic Agents Efficacy and Recommendations for Use. Ann Surg 2010; 251(2): 217-28.
  67. M G. Absorbable hemostatic agents. Am J Heal Syst Pharm 2006; 63(13): 1244-53.
  68. Gabay M, Boucher BA. An Essential Primer for Understanding the Role of Topical Hemostats , Surgical Sealants, and Adhesives for Maintaining Hemostasis. Pharmacotherapy 2013; 33(9): 935-55.
  69. Kamamoto D, Kanazawa T, Ishihara E, Yanagisawa K, Tomita H, Ueda R, et al. Efficacy of a topical gelatin-thrombin hemostatic matrix, FLOSEAL®, in intracranial tumor resection. Surg Neurol Int 2020; 7(11): 16.
  70. Selim Mısırlıoğlu, Engin Türkgeldi, Hande Yağmur, Bülent Urman BA. Use of a gelatin-thrombin hemostatic matrix in obstetrics and gynecological surgery. Turk J Obs Gynecol 2018; 15(3): 193-9.
  71. Chung J, Law T, Chung C, Mak J, Sahota DS, Li TC. Impact of haemostatic sealant versus electrocoagulation on ovarian reserve after laparoscopic ovarian cystectomy of ovarian endometriomas: a randomised controlled trial. BJOG 2019; 126(10): 1267-75.
  72. Lv F, Cong X, Tang W, Han Y, Tang Y, Liu Y, et al. Novel hemostatic agents based on gelatin-microbial transglutaminase mix. Sci China Life Sci 2017; 60(4): 397-403.
  73. Huang L, Liu GL, Kaye AD, Liu H. Advances in Topical Hemostatic Agent Therapies: A Comprehensive Update. Adv Ther 2020; 37(10): 4132-48.
  74. Neveleff DJ. Optimizing Hemostatic Practice Matching the Appropriate Hemostat to the Clinical Situation. AORN J 2012;  96(5): 1-17.
  75. Tan T, Black PM, Ph D. Sir Victor Horsley (1857–1916): Pioneer of Neurological Surgery. Neurosurgery 2002; 50(3): 607-11.
  76. Ltman JESA.  Topical  Hemostatic Agents:  A Review. Dermatol Surg. 2008; 34(4): 431-45.
  77. GEARY JR, KNEELAND FRANTZ V. New absorbable hemostatic bone wax; experimental and clinical studies. Ann Surg 1950; 132(6): 1128-37.
  78. Hill J, Little J, Ford T. Bone wax: a foreign body/giant cell reaction in the foot.  Foot  Ankle  Spec 2013; 6(3):236-8.
  79. Anfinsen OG, Sudmann B, Rait M, Bang G, Sudmann E. Complications secondary to the use of standard bone wax in seven patients. J Foot Ankle Surg 1993; 32(5): 505-8.
  80. Lavigne M, Boddu Siva Rama KR, Doyon J, Vendittoli PA. Bone-wax granuloma after femoral neck osteoplasty. Can J Surg 2008; 51(3): 58-60.
  81. Ateş O. Bone wax can cause foreign body granuloma in the medulla oblongata. Br J Neurosurg 2004; 18(5): 538-40.
  82. Sudmann B, Bang G, Sudmann E. Histologically verified bone wax ( beeswax ) granuloma after median sternotomy in 17 of 18 autopsy cases. Pathology 2006; 38(2): 138-41.
  83. Wang MY, Armstrong JK, Ph D, Fisher TC, Ch B, Meiselman HJ, et al. A New, Pluronic-based, Bone Hemostatic Agent That Does Not Impair Osteogenesis. Neurosurgery 2001; 49(4): 34-7.
  84. Magyar CE, Ph D, Ph D, Atti E. Ostene, a new alkylene oxide copolymer bone hemostatic material, does not inhibit bone healing. Neurosurgery 2008; 63(4): 373-8.
  85. Wellisz T, Armstrong JK, Cambridge J, An YH, Wen X, Hill CM, et al. The Effects of a Soluble Polymer and Bone Wax on Sternal Healing in an Animal Model. Ann Thorac Surg 2008; 85(5): 1776-80.
  86. Frantz VK. ABSORBABLE COTTON, PAPER AND GAUZE: (OXIDIZED CELLULOSE). Ann Sur 1943; 118(1): 116-26.
  87. Spangler D, Rothenburger S, Nguyen K, Jampani H, Weiss S, Bhende S. In vitro antimicrobial activity of oxidized regenerated cellulose against antibiotic-resistant microorganisms. Surg Infect (Larchmt) 2003; 4(3): 255-62.
  88. Schonauer C, Tessitore E, Barbagallo G, Albanese V, Moraci A. The use of local agents: bone wax , gelatin , collagen , oxidized cellulose. Eur Spine J 2004; 13(1): 89-96.
  89. Sileshi B, Achneck HE LJ. Management of surgical hemostasis: topical agents. Vascular 2008; 16(1): 22-8.
  90. Tomizawa Y. Clinical benefits and risk analysis of topical hemostats: a review. J Artif Organs 2005; 8(3): 137-42.
  91. Wang H. Surgicel® (oxidized regenerated cellulose) granuloma mimicking local recurrent gastrointestinal stromal tumor: A case report. Oncol Lett 2013; 5(5): 1497-500.
  92. Igari T, Iwaya F, Abe T, Hagiwara K, Tanji M, Satokawa H, et al. A case of foreign body granuloma after   aortic   valve    replacement.       Kyobu    Geka 1990; 43(7): 550-2. [Article in Japanese]
  93. Banerjee T GK. “Surgiceloma” manifested as cauda equina syndrome. South Med J 1998; 91(5): 481-3.
  94. Develle R, Schaerf R, Najibi S, Conrad J AG. Efficacy and safety of regenerated cellulose topical gauze haemostats in managing secondary haemostasis: a randomised control trial. J Wound Care 2020; 29(11): 670-7.
  95. Aranaz I, Mengíbar M, Harris R, Paños I, Miralles B, Acosta N, et al. Functional Characterization of Chitin and Chitosan. Curr Chem Biol 2009; 3(2): 203-30.
  96. Rowe     RC,  Sheskey  PJ,  Owen  SC.   Handbook of Pharmaceutical Excipients. 5th ed. Washington, DC: Amer Pharmacists Assn; 2006. p. 159-63.
  97. Suzuki SY, Chemistry HM. Protecting Effect of Chitin and Chitosan on Experimentally Induced Murine Candidiasis. Microbiol Immunol 1984; 28(8): 903-12.
  98. Rementer A, Abaitua F, Garc R, Hernando F. Resistance to candidiasis and macrophage activity in chitin-treated mice. FEMS Immunol Med Microbiol 1997; 19(3): 223-30.
  99. Roller S. Antimicrobial Actions of Degraded and Native Chitosan against Spoilage Organisms in Laboratory Media and Foods. Appl Env Microbiol 2000; 66(1): 80-6.
  100. Sano H, Shibasaki K, Matsukubo T TY. Effect of chitosan rinsing on reduction of dental plaque formation. Bull Tokyo Dent Coll 2003; 44(1): 9-16.
  101. Jun Murata, Ikuo Saiki, Kazuhiko Matsuno, Seiichi Tokura  and IA. Inhibition of Tumor Cell Arrest in Lungs by Antimetastatic Chitin Heparinoid. Jpn J Cancer Res 1990; 81(5): 506-13.
  102. Maeda Y, Kimura Y. Nutrition and Cancer Antitumor Effects of Various Low-Molecular-Weight Chitosans Are Due to Increased Natural Killer Activity of Intestinal Intraepithelial Lymphocytes in Sarcoma 180 - Bearing Mice 1. J Nutr 2004; 134(4): 945-50.
  103. Klokkevold PR, Lew DS, Ellis DG, Bertolami CN. Effect of Chitosan on Lingual Hemostasis in Rabbits. J Oral Maxillofac Surg 1991; 49(8): 858-63.
  104. Rao SB, Sharma CP. Use of chitosan as a biomaterial: Studies on its safety and hemostatic potential. J Biomed Mater Res 1997; 34(1): 21-8.
  105. Ishihara M, Nakanishi K, Ono K, Sato M. Photocrosslinkable chitosan as a dressing for wound occlusion and accelerator in healing process. Biomaterials 2002; 23(3): 833-40.
  106. Valeri CR, Srey R, Tilahun D, Ragno G. In Vitro Effects of Poly-N-Acetyl Glucosamine on the Activation of Platelets in Platelet-Rich Plasma with and without Red Blood Cells. J Trauma 2004; 57: 22-5.
  107. Pusateri AE, McCarthy SJ, Gregory KW, Harris RA, Cardenas L, Mcmanus AT, et al. Effect of a chitosan-based hemostatic dressing on blood loss and survival in a model of severe venous hemorrhage and hepatic injury in swine. J Trauma 2003; 54(1): 177–82.
  108. Kozen BG, Kircher SJ, Henao J, Godinez FS, Johnson AS. An alternative hemostatic dressing: comparison of CELOX, HemCon, and QuikClot. Acad Emerg Med 2008; 15(1): 74-81.
  109. Stone CA, Wright H, Clarke T, Powell R, Devaraj VS. Healing at skin graft donor sites dressed with chitosan. Br J Plast Surg 2000; 53(7): 601-6.
  110. Kojima K, Okamoto Y, Kojima K, Miyatake K, Fujise H. Effects of Chitin and Chitosan on Collagen Synthesis in Wound Healing. J Vet Med Sci 2004; 66(12): 1595-8.
  111. Abedi   A,   Hasanzadeh   M,   Lobat   T.   Conductive nanofibrous Chitosan/PEDOT:PSS  tissue  engineering scaffolds. Mater Chem Phys 2019; 237: 121882.
  112. Paul W, Sharma CP. Chitosan and Alginate Wound Dressings: A Short Review. Trends Biomater Artif Organs 2004;18(1): 18-23.
  113. Baldrick P. The safety of chitosan as a pharmaceutical excipient. Regul Toxicol  Pharmacol 2010; 56(3): 290-9.
  114. Jayakumar R, Prabaharan M, Sudheesh Kumar PT, Nair S V, Tamura H. Biomaterials based on chitin and chitosan in wound dressing applications. Biotechnol Adv 2011; 29(3): 322-37.
  115. Haugen HJ, Lyngstadaas SP, Saleh K, Sönnergren HH, Mobed-Miremadi M, Grandio D, et al. Wound Healing Biomaterials. In: Wound Healing Biomaterials. 1st ed. Phildelphia: Elsevier Ltd; 2016. p. 511.
  116. Tago K, Naito Y, Nagata T, Morimura T, Furuya M, Seki T, et al. A ninety-day feeding , subchronic toxicity study of oligo- N -acetylglucosamine in Fischer 344 rats. Food Chem Toxicol 2007; 45(7): 1186-93.
  117. Khan MA , Mujahid M. A review on recent advances in chitosan based composite for hemostatic dressings. Int J Biol Macromol 2019; 124: 138-47.
  118. Lestari W, Yusry WNAW, Haris MS, Jaswir I, Idrus E. A glimpse on the function of chitosan as a dental hemostatic agent. Jpn Dent Sci Rev 2020; 56(1): 147-54.
  119. Mathews S, Kaladhar K, Sharma CP. Cell mimetic monolayer supported chitosan- haemocompatibility studies. J Biomed Mater Res 2006; 79(1): 145-52.
  120. Sagnella S, Mai-ngam K. Chitosan based surfactant polymers designed to improve blood compatibility on biomaterials. Colloids Surf B Biointerfaces 2005; 42(2): 147-55.
  121. Dhawan S, Singla AK, Sinha VR. Evaluation of Mucoadhesive Properties of Chitosan Microspheres Prepared by Different Methods. AAPS PharmSciTech 2004; 5(4): 122-8.
  122. Köksal O, Ozdemir F, Cam Etöz B, Işbil Büyükcoşkun N. Hemostatic effect of a chitosan linear polymer (Celox®) in a severe femoral artery bleeding rat model under hypothermia or warfarin therapy. Ulus Travma Acil Cerrahi Derg 2011; 17(3): 199-204.
  123. Millner R, Lockhart AS, Marr R, Surgery C, Anaesthesia C, Victoria B. Chitosan arrests bleeding in major hepatic injuries with clotting dysfunction: an in vivo experimental study in a model of hepatic injury in the presence of moderate systemic heparinisation. Ann R Coll Surg Engl 2010; 92(7): 559-61.
  124. Arnaud F, Teranishi K, Tomori T, Carr W. Comparison of 10 hemostatic dressings in a groin puncture model in swine. J Vasc Surg 2009; 50(3): 632-9.
  125. Devlin JJ, Kircher S, Kozen BG, Littlejohn LF, Johnson AS. Comparison of ChitoFlex®, CELOXTM, and QuikClot® in Control of Hemorrhage. J Emerg Med 2011; 41(3): 237-45.
  126. Littlejohn LF, Devlin JJ, Kircher SS, Lueken R, Melia MR, Johnson AS. Comparison of Celox-A, ChitoFlex, WoundStat, and combat gauze hemostatic agents versus standard gauze dressing in control of hemorrhage in a swine model of penetrating trauma. Acad Emerg Med 2011; 18(4): 340-50.
  127. Schwartz RB, Reynolds   BZ, Shiver SA,  Lerner   EB, Greenfield EM, Solis RA, et al. Comparison of two packable hemostatic Gauze dressings in a porcine hemorrhage model. Prehosp Emerg Care 2011; 15(4): 477-82.
  128. Sohn   VY,   Eckert MJ, Martin MJ, Arthurs ZM, Perry JR,    Beekley    A, et al.   Efficacy  of   Three   TopicalHemostatic Agents Applied by Medics in a Lethal Groin Injury Model. J Surg Res 2009; 154(2): 258-61.
  129. Valeri CR, Vournakis JN. mRDH Bandage for Surgery and Trauma: Data Summary and Comparative Review. J Trauma 2011; 71(2): 162-6.
  130. Smith AH, Laird C, Porter K, Bloch M. Haemostatic dressings in prehospital care. Emerg Med J 2013; 30(10): 784-9.
  131. Zucker WH, Mason RG. Ultrastructural Aspects of Interactions of Platelets With Microcrystalline Collagen. Am J Pathol 1976; 82(1): 129-42.
  132. Istich JUR, Ohnson PECJ. Comparative in Vitro Analysis of Topical Hemostatic Agents. J Surg Res 1996; 66(2): 100-8.
  133. Ruszczak Z. Effect of collagen matrices on dermal wound healing. Adv Drug Deliv Rev 2003; 55(12): 1595-611.
  134. Mandell SP, Gibran NS. Fibrin sealants: surgical hemostat , sealant and adhesive. Expert Opin Biol Ther 2014; 14(6): 821-30.
  135. Koea JB, Batiller J, Patel B, Shen J, Hammond J, Hart J, et al. A phase III , randomized , controlled , superiority trial evaluating the fibrin pad versus standard of care in controlling parenchymal bleeding during elective hepatic surgery. HPB 2013; 15(1): 61-70.
  136. Genyk Y, Kato T, Pomposelli JJ, Wright JK Jr, Sher LS, Tetens V, et al. Fibrin Sealant Patch (TachoSil) vs Oxidized Regenerated Cellulose Patch (Surgicel Original) for the Secondary Treatment of Local Bleeding in Patients Undergoing Hepatic Resection: A Randomized Controlled Trial. J Am Coll Surg 2016; 222(3): 261-8.
  137. Danker Iii W, DeAnglis A, Ferko N, Garcia D, Hogan A. Comparison of fibrin sealants in peripheral vascular surgery: A systematic review and network meta-analysis. Ann Med Surg 2021; 61: 161-8.
  138. Greenberg JA, Robinson JN, Carabuena JM, Farber MK, Carusi DA. Use of a Fibrin Sealant Patch at Cesarean for Conservative Management of Morbidly Adherent Placenta. AJP Rep 2018; 8(4): 325-7.
  139. Deanda A, Elefteriades JA, Lattouf OM, Ph D, Lazzara RR. Improving Outcomes through the Use of Surgical Sealants for Anastomotic Sealing during Cardiovascular Surgery. J Card Surg 2009; 24(3): 325-33.
  140. Spotnitz WD. Hemostats, sealants, and adhesives: a practical guide for the surgeon. Am Surg 2012; 78(12): 1305-21.
  141. Bhende S, Rothenburger S, Spangler DJ, Dito M. In Vitro Assessment of Microbial Barrier Properties of. Surg Infect 2002; 3(3): 251-7.
  142. Mertz PM, Davis SC, Cazzaniga AL, Drosou A, Eaglstein WH. Barrier and Antibacterial Properties Wound Treatment Films. J Cutan Med Surg 2003; 7(1): 1-6.
  143. Fischer  CP,  Bochicchio  G, Shen J, Patel B, Batiller J, Hart JC. A Prospective , Randomized , Controlled Trial of the Efficacy and Safety of Fibrin Pad as an Adjunct to Control Soft Tissue Bleeding During Abdominal , Retroperitoneal , Pelvic , and Thoracic Surgery. J Am Coll Surg 2013; 217(3): 385-93.
  144. Alicandri  -  Ciufelli  M,  Molinari  G ,  Beckmann    S, Caversaccio M, Presutti L AL. Epinephrine Use in Endoscopic Ear Surgery: Quantitative Safety Assessment. ORL J Otorhinolaryngol Relat Spec 2020; 82(1): 1-7.
  145. Nesbitt NB, Noller MW, Watson NL, Soneru CP, McCoul ED, Riley CA. Outcomes and Complications with Topical Epinephrine in Endoscopic Sinus Surgery: A Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2020; 163(3): 410-7.
  146. Krulewitz NA, Fix ML. Epistaxis. Emerg Med Clin North Am 2019; 37(1): 29-39.
  147. Kristen Whitworth, Jacob Johnson, Samuel Wisniewski MS. Comparative Effectiveness of Topically Administered Tranexamic Acid Versus Topical Oxymetazoline Spray for Achieving Hemostasis in Epistaxis. J Emerg Med 2020; 58(2): 211-6.
  148. El-Menyar A, Sathian B, Asim M, Latifi R A-TH. Efficacy of prehospital administration of tranexamic acid in trauma patients: A meta-analysis of the randomized controlled trials. Am J Emerg Med 2018; 36(6): 1079-87.
  149. Zhang Y, Lang B, Zhao G WF. Hemostatic effect of tourniquet combined with tranexamic acid in total knee arthroplasty: a network meta-analysis. J Orthop Surg Res 2020; 15(1): 530.
  150. Xiong Z, Liu J, Yi P, Wang H TM. Comparison of Intravenous versus Topical Tranexamic Acid in Nondeformity Spine Surgery: A Meta-Analysis. Biomed Res Int 2020; 2020: 7403034.
  151. berle ML, Schechter-Perkins EM AZ. Topical tranexamic acid (TXA) for the management of a bleeding arteriovenous fistula. Am J Emerg Med 2020; 38(2): 407.e5-407.e6.
  152. Hatami F, Valizadeh N, Salehi F HMM. Topical versus low-dose systemic tranexamic acid in pediatric cardiac surgery: A randomized clinical study. J Card Surg 2020; 35(12): 3368-73.
  153. Huebner BR, Dorlac WC CC. Tranexamic Acid Use in Prehospital Uncontrolled Hemorrhage. Wilderness Env Med 2017; 28(2): 50-60.
  154. Montroy J, Hutton B, Moodley P, Fergusson NA, Cheng W, Tinmouth A, Lavallée LT, Fergusson DA BR. The efficacy and safety of topical tranexamic acid: A systematic review and meta-analysis. Transfus Med Rev 2018; 32(3): 165-78.
  155. Yanazume S, Douzono H, Yanazume Y, Iio K, Douchi T. New hemostatic method using Mohs ’ paste for fatal genital bleeding in advanced cervical cancer. Gynecol Oncol Case Rep 2013; 4: 47-9.
  156. Narang U, Mainwaring L, Spath G BJ. In-vitro analysis for microbial barrier properties of 2-octyl cyanoacrylate-derived wound treatment films. J Cutan Med Surg 2003; 7(1): 13-9.
  157. Kakimoto M, Tokita H, Okamura T, Yoshino K. A Chemical Hemostatic Technique for Bleeding from Malignant Wounds. J Palliat Med 2010; 13(1): 11–4.
  158. Miller DT, Roque DM, Santin AD. Use of Monsel solution to treat obstetrical hemorrhage: A review and comparison to other topical hemostatic agents. Am J Obstet Gynecol 2015; 212(6): 725-35.
  159. Ho J, Hruza G. Hydrophilic polymers with potassium salt and microporous polysaccharides for use as hemostatic  agents. Dermatol Surg 2007; 33(12): 1430-3.
  160. Barlev D, Spicknall KE. Histologic findings following use of hydrophilic polymer with potassium ferrate for hemostasis. J Cutan Pathol 2014; 41(12): 959-62.
  161. Hasanzadeh M, Hadavi Moghadam B, Moghadam Abatari AH. New developments in the optimization of electrospinning process. In: Nanopolymers and Modern Materials: Preparation, Properties, and Applications. CRC Press-Taylor & Francis; 2013. p. 297.
  162. Hadavi Moghadam B, Hasanzadeh AH. Some Aspects Of Electrospinning Parameters. In: Nanopolymers and Modern Materials: Preparation, Properties, and Applications. CRC Press-Taylor & Francis; 2013. p. 271.


Sci J Iran Blood Transfus Organ 2021;18(4): 291-312
Review Article
A Review of Hemostatic Agents and Products
Ansari A.1,2, KhosronezhadF.2,3, Shallageh Y.1,2, Zare A.2,4, Afaghi Sh.2,5, Hasanzadeh M.6
1School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2Nanoclub Elites, Tehran, Iran
3Department of Materials Science and Engineering, Sharif University of Technology, Tehran, Iran
4School of Metallurgy and Materials Engineering, University of Tehran, Tehran, Iran
5Faculty of Biomedical Enginnering, Amirkabir University of Technology, Tehran, Iran
6Department of textile engineering, Yazd University, Yazd, Iran
Background and Objectives
Severe hemorrhage is the leading cause of death in comilitary and civilian trauma. Approximately half of road crash fatalities occur due to severe hemorrhage before hospital arrival. In severe cases of bleeding, the use of agents that accelerate blood coagulation (hemostatic agents) is required. The aim of this study was to review on the hemostatic agents and products, from research to commercial stages, and categorizing them based on the physiology of hemostasis. Moreover, the applications and adverse effects of each category have been reviewed and compared; it can be an important step towards optimal clinical application of products and novel original reasearch design continuing the previous studies.
Materials and Methods
Literature search was conducted in scientific databases of PubMed, Scopus, Science Direct, SID, Magiran and IranMedex without filtering release date, by combining related keywords including hemostatic agents, bleeding, dressings and trauma. The abstracts were screened by two reaserchers independently to select the appropriate studies.
In this study, according to the basics of blood coagulation, the hemostatic agents and products were classified into five groups based on the mechanism of action including: (1) coagulants and procoagulants, (2) the concentrators of coagvlant factors, (3) mechanical cougulaton substrates, (4) physiologic coagulants and (5) chemical coagulants. The mechanism of action, applications, and side effects have been compared in each category.
Each hemostatic product can be more effective in special situations, in military and civilian trauma, due to their potency and mechanisms of action.
Key words: Hemostatics, Blood Coagulation Factors, Dressings, Trauma
Received: 15 Dec 2020
Accepted:  6 Oct  2021

Correspondence: Hasanzadeh M., PhD in Textile Engineering. Assistant Professor of Department of textile engineering, Yazd University.
Postal Code: 8915818411, Yazd, Iran. Tel: (+9835) 31232222; Fax: (+9835) 31232222
E-mail: M.hasanzadeh@yazd.ac.ir
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Ansari A, Khosronezhad F, Shallageh Y, Zare A, Afaghi saray S, Hasanzadeh M. A Review of Hemostatic Agents and Products. Sci J Iran Blood Transfus Organ 2021; 18 (4) :291-312
URL: http://bloodjournal.ir/article-1-1373-en.html

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