Skip to main content Accessibility help
×
Home

The utility of FloSeal haemostatic agent in the management of epistaxis

  • M K Khan (a1), M Reda El Badawey (a1) (a2), J Powell (a1) and M Idris (a1)

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.

Copyright

Corresponding author

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

References

Hide All
1Leong, SC, Roe, RJ, Karkanevatos, A. No frills management of epistaxis. Emerg Med J 2005;22:470–2
2Kucik, CJ, Clenney, T. Management of epistaxis. Am Fam Physician 2005;7:305–11
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;32:352–5
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;263:719–22
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;124:3842
6Gurney, TA, Dowd, CF, Murr, AH. Embolization for the treatment of idiopathic posterior epistaxis. Am J Rhinol 2004;18:335–9
7Sacks, R, Sacks, PL, Chandra, R. Chapter 3: Epistaxis. Am J Rhinol Allergy 2013;27(suppl 1):S910
8Cote, D, Barber, B, Diamond, C, Wright, E. FloSeal hemostatic matrix in persistent epistaxis: prospective clinical trial. Otolaryngol Head Neck Surg 2010;39:304–8
9Oz, MC, Rondinone, JF, Shargill, NS. FloSeal Matrix: new generation topical hemostatic sealant. J Card Surg 2003;18:486–93
10Baumann, A, Caversaccio, M. Hemostasis in endoscopic sinus surgery using a specific gelatin-thrombin based agent (FloSeal). Rhinology 2003;41:244–9
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;120:495–8
12Jameson, M, Gross, CW, Kountakis, SE. FloSeal use in endoscopic sinus surgery: effect on postoperative bleeding and synechiae formation. Am J Otolaryngol 2006;27:8690
13Mathiasen, RA, Cruz, RM. Prospective, randomized, controlled clinical trial of a novel matrix hemostatic sealant in patients with acute anterior epistaxis. Laryngoscope 2005;115:899902
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;94:336–9
15Melia, L, McGarry, G. Epistaxis in adults: a clinical review. Br J Hosp Med (Lond) 2008;69:404–7
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;17:51–5
17Chandra, RK, Conley, DB, Haines, GK 3rd, Kern, RC. Long-term effects of FloSeal packing after endoscopic sinus surgery. Am J Rhinol 2005;19:240–3
18Clapp, B, Santillan, A. Small bowel obstruction after FloSeal use. JSLS 2011;15:361–4
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;13:226–8
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;21:174–9

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed