What is hemostatis?
Hemostasis is the process by which bleeding tissue and damaged blood vessels stop bleeding. In other words, hemostasis allows for the blood in damaged blood vessels to remain within the vessel instead of seeping outward. It's the first necessary step to healing a wound and it consists of coagulation, which is the blood changing from a liquid form to a gel-like substance.
Intact blood vessels are essential to preventing the formation of clots. Certain cells in the intact vessels, namely endothelial cells, possess a heparin-like molecule as well as thrombomodulin that prevent clotting and prostacyclin and nitric oxide that prevent the aggregation of platelets. However, when the endothelial cells are compromised or damaged, they effectively stop the secretion of these molecules. Instead, the endothelial cells begin to secrete the von Willebrand factor which initiates coagulation. This allows for the closing of the vessel and the healing of the wound.
Hemostatis has three steps, which are:
- The production of a platelet plug that serves as a temporary block for the vessel.
- Blood coagulation, also known as a fibrin clot.
The above steps and processes are all necessary to start healing and to seal the hole in the vessel until the tissues are able to be repaired completely during the gradual healing process. During surgery, blood vessel damage is an inevitable side effect of incisions and lacerations, making efficient, successful hemostasis an absolute must. In order to facilitate speedy hemostasis during surgery, the process must be facilitated using agents known as hemostats. This begs the following question; what is a hemostat?
What is a hemostat?
So exactly what is a hemostat? A hemostat is a device or product that facilitates hemostasis, or the clotting and coagulation of blood. Hemostatic agents are essential during surgical procedures as a means of controlling bleeding. When considering the "what is a hemostat" question, it's important to consider the products' role in limiting blood loss during surgery. This crucial task is imperative not only to controlling bleeding, but also to facilitating quicker recovery and healing. So what is a hemostat in terms of material? Hemostats can consist of either instruments such as tissue holders and clamps as well as absorbable hemostats such as Surgicel hemostat. These patches, which are composed of special materials, are designed to control bleeding and then to be absorbed into the surrounding tissue during healing.
Why are hemostatic agents needed?
Now that the "what is a hemostat" question has been answered, the next step is to better understand why hemostatic agents are so essential. There are a number of situations in which hemostatic agents are imperative, surgery being one of them.
During surgery, bleeding is a unavoidable side effect but one that must be controlled in order to prevent catastrophic effects, such as bleeding out and severe peri- and postoperative anemia. Surgeons have long been looking for a solution to problematic bleeding that yields an efficient, first try result. An innovative absorbable hemostat such as Surgicel provides just such a solution as it offers minimal surgical disruptions and reduces the chance of problematic bleeding during surgery.
Hemostatic agents provide a necessary service and neglecting to utilize the proper hemostatic agents can have a number of negative, potentially catastrophic results, such as:
- An increased risk of perioperative complications as well as mortality in the patient.
- Increased blood loss as well as an increased risk of necessary blood transfusions.
- Extended operating times.
- The increased use of other surgical instruments and resources
Due to the significant damage inefficient hemostats can cause, significant developments have been made in the industry of absorbable hemostats over the last several decades. These innovative, state-of-the-art products have come a long way in helping surgeons to maintain better control of their results during surgery and to ensure that their patients experience as little bleeding as possible both before and after the procedure.
What is Surgicel?
The Surgicel dressing is a hemostat that is derived from plant matter and is composed of an oxidized cellulose polymer that was developed and manufactured by Ethicon, a subsidiary of Johnson and Johnson. Originally created in 1947, the Surgicel dressing is used as a means of controlling bleeding during and post surgery. It can even be used outside of the operating room as a means of controlling bleeding and causing coagulation in certain wounds.
Surgicel hemostat is used during many surgeries, especially those that are oral and/or maxillofacial in nature. Used as a means of controlling bleeding, Surgicel hemostat is also commonly used following newborn circumcision as well when pressure is not adequate to control the bleeding that occurs. Surgicel dressing is effective in many different scenarios, and many surgeons have grown to depend upon this innovative dressing technology. There are a number of sizes of Surgical dressing available, making it ideal for many different situations and needs. Now that you better understand what Surgicel is, the next step is to answer the question, "how does Surgicel work?".
How does Surgicel work?
So the next question to answer is "how does Surgicel work"? The Surgicel dressing works by melding into the damaged tissue of an open wound. As an absorbable hemostat, it virtually blends into the wound and serves as a means of temporarily coagulating the blood so as to reduce bleeding and minimize complications during and after surgery until the tissue heals. As a flexible patch, it works easily and well to form clots and can be easily and quickly applied by the surgeon. The cellulose from which Surgicel is composed is a key component of the answer to "how does Surgicel work". This cellulose polymer breaks down when in contact with moisture and reduces its pH, which means it becomes more acidic in nature. An acidic environment is integral to preventing infection as a low pH makes the area resistant to bacteria, and any bacteria that exists in the area will become less active and/or will die.
Part of the beauty of the Surgicel dressing is that it is easy to use and is effective right out of the box without any preparation or addition of moisture. There is no need for any treatment of the dressing; instead, it can be directly placed on an open wound and/or vessel to stop the bleeding.
Surgicel hemostat works in a three step process, which proceeds as follows:
- The surgeon places the Surgicel hemostat on the open wound or damaged tissue and vessels and compresses the Surgicel dressing for three minutes.
- The hemostat stimulates the production of thrombin and fibrinogen, which facilitates coagulation of the blood.
- The adhesive properties of the Surgicel hemostat form a seal that prevents bleeding.
Surgicel hemostat is an absorbable hemostat that is naturally absorbed by the body within an eight week period. No muss, no fuss; this absorbable hemostat is ideal for both surgeons and patients alike due to its ease of use and seamless integration into the surrounding tissue.
What are the noted advantages of Surgicel hemostat?
There are a number of benefits attributed to the Surgicel absorbable hemostat. Surgicel is a lightweight, layered hemostat that consists of four layers that are able to adhere to and blend into damaged tissue. Two of the most noted advantages attributed to this absorbable hemostat are as follows:
How does Surgicel work? It works by quickly blending into bleeding tissue and blocking bleeding. This makes it far more efficient than other alternatives, with Surgicel being shown to:
- Decrease the need for other hemostatic products during surgical procedures.
- Decrease costs attributed to the need for intensive care.
- Reduce the length of any necessary hospital stays.
- Reduce the likelihood of the patient requiring a blood transfusion.
The four different layers of Surgicel are easily able to be separated and are therefore simple to customize to allow for ideal placement on the tissue. The layers are all lightweight, making them even easier to use and to adhere to the tissue. Surgicel has been shown to be one of the easiest, simplest to use hemostats available, and many surgeons have turned to this innovate product for surgical purposes.
What are the types of Surgicel available?
Since the inception of Surgical in the 1940s, there have been many developments in the product and more advancements every year have been made to make the hemostat more effective and easier to use. There are four types of Surgicel that have been made and developed over the past several decades. These four types of Surgicel include the:
- Original Surgicel, which consisted of a mesh that was used to adhere the dressing to the tissue.
- Surgicel Snow, an improved version that worked almost thirty three percent faster and adhered far better than the original.
- Surgicel Nu-Knit, which could be sutured into place with ease by the surgeon.
- Surgicel Fibrillar, which could be shredded, compacted, and moistened in order to be molded into shape and placed on the affected tissue or wound.
Are there any limitations to Surgicel use?
It's important to note when answering the "how does Surgicel work" question that there are also limitations to the use of this efficient product. While Surgicel can be used for a number of procedures and wounds, there are some situations in which Surgicel is not intended for use. For example, Surgicel:
- Is not a replacement for sutures or ligation methods.
- Shouldn't be used for children who are less than one month old.
New Fundamentals in Hemostasis
Topical hemostatic agents in surgery: review and prospects
On to you
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CEO, Save Rite Medical
With a vision to deliver the best service to the community, Marc Kaplan created Save Rite Medical. Built on the pillars of educating, the company was founded to help customers find the best products and learn how to use them. Save Rite Medical offers brand name and cost savings alternatives to help you discover the best options for your needs.