Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-26T18:19:04.228Z Has data issue: false hasContentIssue false
  • English
  • Français

The utility of FloSeal haemostatic agent in the management of epistaxis

Published online by Cambridge University Press:  17 March 2015

M K Khan ,
M Reda El Badawey ,
J Powell  and
M Idris
M K Khan*
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle upon Tyne, UK
M Reda El Badawey
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle upon Tyne, UK Department of Otolaryngology, Tanta University, Egypt
J Powell
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle upon Tyne, UK
M Idris
Affiliation:
Department of Otolaryngology, Freeman Hospital, Newcastle upon Tyne, UK
*
Address for correspondence:Dr Muhammad Kamaal Khan, Department of Otolaryngology, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK Fax: 0191 223 1246 E-mail: kamaalkhan@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

FloSeal, a locally applied haemostatic agent, has been shown to be effective in a variety of clinical situations. This study investigated its potential benefits in the management of epistaxis.

Methods:

The outcomes of a series of patients with epistaxis presenting to one ENT unit, over a two-month period, were compared. Patients were either treated with FloSeal or traditional epistaxis management techniques. Success of FloSeal was classed as complete haemostasis after its application, without the need for further interventions and no readmission with epistaxis within 7 days.

Results:

Our study comprised 101 adults, with a mean age of 70 years (range, 22–98 years). The overall success rate for FloSeal was 14 per cent (5 out of 36 cases). It was successful in 66 per cent of anterior epistaxis cases (2 out of 3) and in only 9 per cent of posterior epistaxis cases (3 out of 33). There was a significantly higher failure rate of FloSeal compared with nasal packing in posterior epistaxis (p < 0.001).

Conclusion:

Our findings suggest that FloSeal has a limited role in the management of epistaxis.

Keywords

EpistaxisFloSeal MatrixAdultsHemostasisHemorrhage
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 4 , April 2015 , pp. 353 - 357
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Leong, SC, Roe, RJ, Karkanevatos, A. No frills management of epistaxis. Emerg Med J 2005;22:470–2CrossRefGoogle ScholarPubMed
2Kucik, CJ, Clenney, T. Management of epistaxis. Am Fam Physician 2005;7:305–11Google Scholar
3Bresnihan, M, Mehigan, B, Curran, A. An evaluation of Merocel and Series 5000 nasal packs in patients following nasal surgery: a prospective randomised trial. Clin Otolaryngol 2007;32:352–5CrossRefGoogle ScholarPubMed
4Moumoulidis, I, Draper, MR, Patel, H, Jani, P, Price, T. A prospective randomised controlled trial comparing Merocel and Rapid Rhino nasal tampons in the treatment of epistaxis. Eur Arch Otorhinolaryngol 2006;263:719–22CrossRefGoogle ScholarPubMed
5Kilty, SJ, Al-Hajry, M, Al-Mutairi, D, Bonaparte, JP, Duval, M, Hwang, E et al. Prospective clinical trial of gelatin-thrombin matrix as first line treatment of posterior epistaxis. Laryngoscope 2014;124:38–42CrossRefGoogle ScholarPubMed
6Gurney, TA, Dowd, CF, Murr, AH. Embolization for the treatment of idiopathic posterior epistaxis. Am J Rhinol 2004;18:335–9CrossRefGoogle ScholarPubMed
7Sacks, R, Sacks, PL, Chandra, R. Chapter 3: Epistaxis. Am J Rhinol Allergy 2013;27(suppl 1):S9–10CrossRefGoogle ScholarPubMed
8Cote, D, Barber, B, Diamond, C, Wright, E. FloSeal hemostatic matrix in persistent epistaxis: prospective clinical trial. Otolaryngol Head Neck Surg 2010;39:304–8Google ScholarPubMed
9Oz, MC, Rondinone, JF, Shargill, NS. FloSeal Matrix: new generation topical hemostatic sealant. J Card Surg 2003;18:486–93CrossRefGoogle ScholarPubMed
10Baumann, A, Caversaccio, M. Hemostasis in endoscopic sinus surgery using a specific gelatin-thrombin based agent (FloSeal). Rhinology 2003;41:244–9Google Scholar
11Beyea, JA, Rotenberg, BW. Comparison of purified plant polysaccharide (HemoStase) versus gelatin-thrombin matrix (FloSeal) in controlling bleeding during sinus surgery: a randomized controlled trial. Ann Otol Rhinol Laryngol 2011;120:495–8Google Scholar
12Jameson, M, Gross, CW, Kountakis, SE. FloSeal use in endoscopic sinus surgery: effect on postoperative bleeding and synechiae formation. Am J Otolaryngol 2006;27:86–90CrossRefGoogle ScholarPubMed
13Mathiasen, RA, Cruz, RM. Prospective, randomized, controlled clinical trial of a novel matrix hemostatic sealant in patients with acute anterior epistaxis. Laryngoscope 2005;115:899–902CrossRefGoogle ScholarPubMed
14Ujam, A, Awad, Z, Wong, G, Tatla, T, Farrell, R. Safety trial of FloSeal(®) haemostatic agent in head and neck surgery. Ann R Coll Surg Engl 2012;94:336–9Google Scholar
15Melia, L, McGarry, G. Epistaxis in adults: a clinical review. Br J Hosp Med (Lond) 2008;69:404–7Google Scholar
16Chandra, RK, Conley, DB, Kern, RC. The effect of FloSeal on mucosal healing after endoscopic sinus surgery: a comparison with thrombin-soaked gelatin foam. Am J Rhinol 2003;17:51–5Google Scholar
17Chandra, RK, Conley, DB, Haines, GK 3rd, Kern, RC. Long-term effects of FloSeal packing after endoscopic sinus surgery. Am J Rhinol 2005;19:240–3CrossRefGoogle ScholarPubMed
18Clapp, B, Santillan, A. Small bowel obstruction after FloSeal use. JSLS 2011;15:361–4Google Scholar
19Shashoua, AR, Gill, D, Barajas, R, Dini, M, August, C, Kirschenbaum, GL et al. Caseating granulomata caused by hemostatic agent posing as metastatic leiomyosarcoma. JSLS 2009;13:226–8Google ScholarPubMed
20Shrime, MG, Tabaee, A, Hsu, AK, Rickert, S, Close, LG. Synechia formation after endoscopic sinus surgery and middle turbinate medialization with and without FloSeal. Am J Rhinol 2007;21:174–9Google Scholar