A comparative evaluation of absorbable haemostatics.

An absorbable haemostatic is a material which acts as a haemostat but is subsequently itself absorbed in the tissues, leaving no trace. Such a material is of use in certain cases of haemorrhage which it is impossible or impractical to control by more direct methods. Since haemostasis was at all times one of the primary aims of surgery, it is obvious that the search for such materials is of long standing. Study of the history of surgery readily confirms this view. Ambroise Pare (egg yolk), Perthe (defibrinated blood), Broca (serum), Cushing and Horsley (muscle stamps) are some of the illustrious names associated with the earlier absorbable haemostatics. The impetus of the last Great War produced further such materials, fibrin foam (Bailey et al., I944), oxidized cellulose (Frantz et al., I944), gelatin sponge (Correll et al., i944) and alginates (Blaine, 1945) being developed during this period. Of these four substances the first three were developed in the United States, the last in Britain. Gelatin sponge is now also produced in this country as well as on the Continent. Whilst clinically all four materials have their protagonists and critics, it is commonly agreed that their haemostatic effect 'is satisfactory. Opinions differ as to their times of absorption. A review of the relevant properties of absorbable haemostatics seems therefore not out of place.