====== Gelatin Thrombin Matrix sealant ======


see [[Floseal]]

see [[Surgiflo]]
----
Few studies have been published about [[percutaneous]] techniques for the [[management]] of surgical bed [[hemorrhage]] during a [[stereotactic biopsy]], a serious [[complication]] that may affect patient [[outcome]]. 

de Quintana-Schmidt et al. from the [[University Hospital de la Santa Creu i Sant Pau]], describe the injection of a [[thrombin]]-[[gelatin]] matrix through the [[biopsy]] [[cannula]] as an effective method to arrest surgical bed bleeding that does not respond to conventional methods of hemostasis.

They prospectively documented image-guided stereotactic brain biopsy procedures on 30 awake patients between July 2014 and July 2017. Among those patients presenting with intractable surgical bed [[bleeding]], a thrombin-gelatin matrix injection was used through the biopsy cannula. Details of the injection technique, surgical outcome and complications were recorded.

They documented 30 stereotactic brain biopsies. 3 (10%) of these cases had intractable surgical bed bleeding during the procedure. In all 3 cases, thrombin-gelatin matrix was injected and an immediate arrest was achieved. Neither of the patients required a [[craniotomy]] or further invasive measure to achieve the hemostasis. No postoperative complications were recorded.

This preliminary results suggest that the thrombin-gelatin matrix injection is a simple, safe and effective stereotactic practice to manage persistent surgical bed bleeding that cannot be arrested by standard, conventional hemostatic methods
((de Quintana-Schmidt C, Leidinger A, Teixidó JM, Bertrán GC. Application of a
thrombin-gelatin matrix in the management of intractable hemorrhage during
stereotactic biopsy: a Technical Note. World Neurosurg. 2018 Oct 13. pii:
S1878-8750(18)32350-7. doi: 10.1016/j.wneu.2018.10.053. [Epub ahead of print]
PubMed PMID: 30326309.
)).