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Antihemorrhagic agents used in medicine have various mechanisms of action:
Hemostatic agents are used during surgical procedures to achieve hemostasis and are categorized as hemostats, sealants and adhesives. They vary based on their mechanism of action, composition, ease of application, adherence to tissue, immunogenicity and cost. These agents permit rapid hemostasis, better visualization of the surgical area, shorter operative times, decreased requirement for transfusions, decreased wound healing time and overall improvement in patient recovery time.
Topical hemostatic agents have been gaining popularity for use in emergency bleeding control, especially in military medicine. They are available in two forms—as a granular powder poured on wounds, or embedded in a dressing.
Microfibrillar collagen hemostat (MCH) is a topical agent composed of resorbable microfibrillar collagen. It attracts platelets and allows for the formation of a blood clot when it comes into contact with blood. Unlike the hemostatic clamp, no mechanical action is involved. The surgeon presses the MCH against a bleeding site, and the collagen attracts and helps with the clotting process to eventually stop bleeding.
The practical application for MCH is different from that of the hemostatic clamp.
Chitosan hemostats are topical agents composed of chitosan and its salts. Chitosan bonds with platelets and red blood cells to form a gel-like clot which seals a bleeding vessel. Unlike other hemostat technologies its action does not require the normal hemostatic pathway and therefore continues to function even when anticoagulants like heparin are present.
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