Thromboembolic events from the intraoperative use of topical gelatin and albumin-glutaraldehyde haemostatic agents

BackgroundAn under-recognised complication of gelatin-based [GBA] and albumin-glutaraldehyde-based haemostat agents [AGA] is their potential to embolise. This review aims collate analyse cases reported in the literature perioperative thromboembolic phenomena secondary locally applied GBA AGA agents. Methods An electronic search was performed on databases Embase, Ovid Medline, Proquest, Scopus Pubmed. 8875 articles were reviewed from title abstract. After exclusion criteria duplicates removed, 13 with 18 included for analysis. Data extracted each patient demographics, surgery type, haemostatic agent used, clinical features, radiology pathological findings, associated morbidity mortality. ResultsThromboembolic events fourteen secondaries four AGA. Cases twelve pulmonary emboli, three peripheral two cerebral emboli one coronary embolus. Embolic most common following spinal orthopaedic patients [43%], Type A Aortic dissection repair [100%]. The application 10ml or more frequently [64%]. Six fatal. time course event ranged occurring intraoperatively 45 days post-operation. ConclusionGBA are venous arterial embolisation high overall over an unclear bleeding site poses a risk embolisation. Surgical fields should be dried before Quantities > 10mL reported. can occur anywhere immediate postoperatively.