薬理と治療

Abstract

Hemostats play an important role in all surgical procedures, and directly correlate to their outcomes. A lot of hemostats, including sealants and adhesives, are being currently utilized, and novel materials with different mechanism from present hemostats are being developed. However, there are few, if any, clinical prospective and randomized trials to demonstrate their efficacy and safety in all hemostats. Although surgeons considerably depends upon their own experiences at the usage, they need to exactly understand each characteristics of hemostats, not only for ability to stem bleeding, but also for safety. In this review, current used hemostats in Japan are grouped into 7 category, which includes fibrin, collagen, gelatin, cellulose, glutaraldehyde, polysaccharide, and polymer based materials. Recently, population ageing related to tendency of bleeding and novel oral anticoagulants complicate hemostasis in surgery. In order to adequately adapt the difficulties, updated information of hemostats and future perspectives are provided.