Clinical use of topical thrombin as a surgical hemostat

Wesley K Lew1, Fred A Weaver21University of Southern California, Department of Surgery, Los Angeles, CA, USA; 2CardioVascular Thoracic Institute at the University of Southern California, Los Angeles, CA, USAAbstract: When surgical ligation of bleeding fails, or is not possible, surgeons rely on a nu...

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Autores principales:	Wesley K Lew, Fred A Weaver
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/7f3fb2ae73df4be09d8aac4d0b2ba663
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spelling	oai:doaj.org-article:7f3fb2ae73df4be09d8aac4d0b2ba6632021-12-02T05:46:26ZClinical use of topical thrombin as a surgical hemostat1177-54751177-5491https://doaj.org/article/7f3fb2ae73df4be09d8aac4d0b2ba6632008-08-01T00:00:00Zhttp://www.dovepress.com/clinical-use-of-topical-thrombin-as-a-surgical-hemostat-a1930https://doaj.org/toc/1177-5475https://doaj.org/toc/1177-5491Wesley K Lew1, Fred A Weaver21University of Southern California, Department of Surgery, Los Angeles, CA, USA; 2CardioVascular Thoracic Institute at the University of Southern California, Los Angeles, CA, USAAbstract: When surgical ligation of bleeding fails, or is not possible, surgeons rely on a number of hemostatic aids, including thrombin. This review discusses the history, pharmacology and clinical application of thrombin as a surgical hemostat. The initial thrombin was bovine in origin, but its use has been complicated by the formation of antibodies that cross react with human coagulation factors. This has been associated with life threatening bleeding and in some circumstances anaphylaxis and death. Human thrombin, isolated from pooled plasma of donors, has been developed in an effort to minimize these risks, but its downside is the potential of transmitting blood-borne pathogens and limited availability. Recently a recombinant thrombin has been developed and approved for use by the FDA. It has the advantage of being minimally antigenic and devoid of the risk if viral transmission. Thrombin is often used in conjunction with other hemostatic aids, including absorbable agents (like gelfoam, collagen, and cellulose), and with fibrinogen in fibrin glues. The last part of this review will discuss these agents in detail, and review their clinical applications.Keywords: bovine, recombinant, human, thrombin, antigenicity, antibodies Wesley K LewFred A WeaverDove Medical PressarticleMedicine (General)R5-920ENBiologics: Targets & Therapy, Vol 2008, Iss Issue 4, Pp 593-599 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Wesley K Lew Fred A Weaver Clinical use of topical thrombin as a surgical hemostat
description	Wesley K Lew1, Fred A Weaver21University of Southern California, Department of Surgery, Los Angeles, CA, USA; 2CardioVascular Thoracic Institute at the University of Southern California, Los Angeles, CA, USAAbstract: When surgical ligation of bleeding fails, or is not possible, surgeons rely on a number of hemostatic aids, including thrombin. This review discusses the history, pharmacology and clinical application of thrombin as a surgical hemostat. The initial thrombin was bovine in origin, but its use has been complicated by the formation of antibodies that cross react with human coagulation factors. This has been associated with life threatening bleeding and in some circumstances anaphylaxis and death. Human thrombin, isolated from pooled plasma of donors, has been developed in an effort to minimize these risks, but its downside is the potential of transmitting blood-borne pathogens and limited availability. Recently a recombinant thrombin has been developed and approved for use by the FDA. It has the advantage of being minimally antigenic and devoid of the risk if viral transmission. Thrombin is often used in conjunction with other hemostatic aids, including absorbable agents (like gelfoam, collagen, and cellulose), and with fibrinogen in fibrin glues. The last part of this review will discuss these agents in detail, and review their clinical applications.Keywords: bovine, recombinant, human, thrombin, antigenicity, antibodies
format	article
author	Wesley K Lew Fred A Weaver
author_facet	Wesley K Lew Fred A Weaver
author_sort	Wesley K Lew
title	Clinical use of topical thrombin as a surgical hemostat
title_short	Clinical use of topical thrombin as a surgical hemostat
title_full	Clinical use of topical thrombin as a surgical hemostat
title_fullStr	Clinical use of topical thrombin as a surgical hemostat
title_full_unstemmed	Clinical use of topical thrombin as a surgical hemostat
title_sort	clinical use of topical thrombin as a surgical hemostat
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/7f3fb2ae73df4be09d8aac4d0b2ba663
work_keys_str_mv	AT wesleyklew clinicaluseoftopicalthrombinasasurgicalhemostat AT fredaweaver clinicaluseoftopicalthrombinasasurgicalhemostat
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Clinical use of topical thrombin as a surgical hemostat

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