Can surgical gel foam be used to stop bleeding in a cavity?

Use of Surgical Gel Foam for Cavity Bleeding Control

Yes, absorbable gelatin sponge (surgical gel foam) can be effectively used to stop bleeding in a cavity and is recommended as a local hemostatic measure during surgical procedures. 1

Mechanism of Action and Effectiveness

• Absorbable gelatin sponge works by swelling when in contact with blood, which reduces blood flow and creates a physical matrix that enhances clot formation 2
• When applied to a bleeding site, gelatin matrix immediately absorbs blood flowing from wounds and activates the autologous components in the absorbed blood that promote coagulation 3
• The hemostatic effect is significantly enhanced when gelatin foam is combined with thrombin, with higher concentrations of thrombin (770 IU/mL) yielding improved hemostasis compared to lower concentrations 4
• Microfibrillar collagen directly triggers platelet aggregation, resulting in clot formation when in contact with a bleeding surface 2

Clinical Applications

• Absorbable gelatin sponge is specifically mentioned in clinical guidelines as an effective local measure to reduce bleeding during dental and oral surgical procedures 1
• It can be used in combination with sutures to control bleeding effectively during invasive procedures 1
• Gel foam has been successfully used for controlling bleeding in various cavities, including:
  • Dental/oral cavities 1, 5
  • Abdominal cavities during surgery 3
  • Liver lesions 4
  • Gastric bleeding (in embolization procedures) 6

Practical Application Tips

• For optimal results, the gelatin sponge should be applied directly to the bleeding site with gentle pressure 3
• In cases of more severe bleeding, combining gel foam with thrombin significantly improves hemostatic efficacy 4
• Two-layer sheets of gelatin (combining sponge and film) have demonstrated superior hemostatic effects compared to some other hemostatic agents 3
• For surgical procedures where anticoagulants cannot be stopped, absorbable gelatin sponges with or without thrombin may be particularly useful 1

Advantages and Considerations

• Gelatin-based hemostatic agents have shown fewer inflammatory reactions compared to some other hemostatic materials 3
• The material can be easily removed after clotting, avoiding secondary wound injury 5
• Gelatin solutions are excreted with urine and feces in unchanged form without prolonged fixation in the organism 7
• Adverse reactions such as anaphylactoid or anaphylactic responses to gelatin derivatives are rare 7

Cautions

• In patients with compromised vascular supply, there is a potential risk of ischemic complications when using gel foam for embolization procedures 6
• The European guideline on management of major bleeding following trauma mentions that absorbable gelatin sponges with or without thrombin may be useful in difficult cases but are rarely required for more routine procedures 1

Surgical gel foam is a well-established hemostatic agent that can be effectively used to control bleeding in various cavities, with its efficacy enhanced when combined with thrombin. Its ability to swell when in contact with blood and provide a physical matrix for clot formation makes it particularly useful in surgical settings.