Use of Floseal(R), a human gelatine-thrombin matrix sealant, in surgery: a systematic review (BMC Surgery)

Background: Surgical bleeding can be associated with an increased risk of morbidity and mortality across all surgical areas. Thus, numerous products have been developed to achieve haemostasis. A flowable haemostatic matrix such as Floseal(R) can quickly and reliably stop bleeding across the full spectrum of bleeding scenarios. The aim of this study was to systematically review clinical and economic evidence regarding the use of Floseal(R) in surgical procedures. Methods: An extensive literature search was conducted in PubMed, EMBASE, and the Cochrane Library over the period spanning 2003-2013 to identify publications related to Floseal(R) use in all types of surgical procedures. Case reports and case series studies were excluded. Results: A total of 27 papers met the selection criteria and were analysed. In the studies, blood loss and the time to achieve haemostasis were the most reported outcomes used to assess the efficacy of Floseal(R). The majority of published studies (64%) examined the use of Floseal(R) compared with conventional methods (such as electrocautery or suturing). The remaining 36% of the studies evaluated the use of Floseal(R) compared with other haemostatic agents, such as Surgicel(R), Gelfoam(R), and Hemostase(R). FloSeal(R) has been demonstrated to be an efficacious method in surgical procedures to reduce the time to achieve haemostasis, the frequency of intra- and postoperative bleeding, and the length of hospital stay, among other primary outcomes, resulting in less consumption of health resources. Conclusions: The majority of the selected studies confirmed that Floseal(R) showed improvements over other haemostatic agents in achieving haemostasis and reducing blood loss.