Hemostasis in the Surgical Field

Hemostatic mechanisms are an integral a part of the human physiology. Traditionally divided into intrinsic and extrinsic arms, the coagulation cascade converges, through the interactions of the many various factors, at a standard element—thrombin. As a consequence, variety of various agents is developed to supplement this common, critical step to assist surgical hemostasis. Intraoperative interventions most ordinarily include sutures and heat-generating cautery devices; however, these methods are sometimes insufficient or inappropriate for a selected procedure or anatomic location, resulting in the event of other adjunctive therapies, including topical hemostats. Topical hemostatic agents generally act as active, passive, and combinations therapies, counting on their individual composition and mode of action. We offer a quick review of the traditional coagulation cascade, including critical points, followed by a discussion of surgical strategies and adjuctive therapies want to achieve surgical hemostasis and concluding with a discussion of topical thrombins.