absorbable gelatin sponge


Summary: Sterile, gelatin-base surgical sponge applied topically as an adjunct to hemostasis when the control of bleeding by conventional procedures is ineffective to reduce capillary ooze or is impractical. (From AMA Drug Evaluations Annual, 1994, p797)

Top Publications

  1. Pursifull N, Morris M, Harris R, Morey A. Damage control management of experimental grade 5 renal injuries: further evaluation of FloSeal gelatin matrix. J Trauma. 2006;60:346-50 pubmed
    ..The absence of delayed bleeding and nephrotoxicity suggests a possible increased role for FloSeal in the treatment of devastating renal injuries in damage control surgery. ..
  2. Singh P, Mandhani A. Use of absorbable gelatin sponge as an adjunct to "totally tubeless percutaneous nephrolithotomy". Arch Esp Urol. 2009;62:423-9 pubmed
    To study the efficacy and safety of totally tubeless percutaneous nephrolithotomy (PNL) using absorbable gelatin sponge as an adjunct...
  3. Oz M, Rondinone J, Shargill N. FloSeal Matrix: new generation topical hemostatic sealant. J Card Surg. 2003;18:486-93 pubmed
  4. Dogulu F, Durdag E, Cemil B, Kurt G, Ozgun G. The role of FloSeal in reducing epidural fibrosis in a rat laminectomy model. Neurol Neurochir Pol. 2009;43:346-51 pubmed
    ..Application of FloSeal at a laminectomy site may be useful to decrease adhesion at the interface between the dura mater and epidural fibrosis. ..
  5. Kaufmann O, Sountoulides P, Kaplan A, Louie M, McDougall E, Clayman R. Skin treatment and tract closure for tubeless percutaneous nephrolithotomy: University of California, Irvine, technique. J Endourol. 2009;23:1739-41 pubmed publisher
  6. Zeltser I, Dugi D, Gupta A, Park S, Kabbani W, Cadeddu J. Does topical haemostatic agent have an adverse effect on the function of the prostatic neurovascular bundle?. BJU Int. 2008;102:1005-7 pubmed publisher
    ..In this short-term functional study, FloSeal did not adversely affect cavernous nerve function, measured as the erectile response to electrical stimulation. We found no evidence contraindicating its use during radical prostatectomy. ..
  7. Hobday C, Milam M, Milam R, Euscher E, Brown J. Postoperative small bowel obstruction associated with use of hemostatic agents. J Minim Invasive Gynecol. 2009;16:224-6 pubmed publisher
    ..Use of hemostatic agents should be considered as a cause in the differential diagnosis of patients with early postoperative SBO...
  8. Ebert A, Hollauer A, Fuhr N, Langolf O, Papadopoulos T. Laparoscopic ovarian cystectomy without bipolar coagulation or sutures using a gelantine-thrombin matrix sealant (FloSeal): first support of a promising technique. Arch Gynecol Obstet. 2009;280:161-5 pubmed publisher
  9. Testini M, Marzaioli R, Lissidini G, Lippolis A, Logoluso F, Gurrado A, et al. The effectiveness of FloSeal matrix hemostatic agent in thyroid surgery: a prospective, randomized, control study. Langenbecks Arch Surg. 2009;394:837-42 pubmed publisher
    ..Tabotamp) resulting in shorter postoperative hospital stay in the FloSeal group (p = 0.02 vs. surgical; p = 0.002 vs. Tabotamp). FloSeal matrix is an effective additional agent to conventional haemostatic procedures in thyroid surgery. ..

More Information


  1. Ereth M, Schaff M, Ericson E, Wetjen N, Nuttall G, Oliver W. Comparative safety and efficacy of topical hemostatic agents in a rat neurosurgical model. Neurosurgery. 2008;63:369-72; discussion 372 pubmed publisher
    ..Arista degrades more rapidly than Surgicel, Avitene, and FloSeal and does not result in any foreign body reaction. ..
  2. Henkel A, Cooper R, Ward K, Bova D, Yao K. Malignant-appearing microcalcifications at the lumpectomy site with the use of FloSeal hemostatic sealant. AJR Am J Roentgenol. 2008;191:1371-3 pubmed publisher
    ..Application of FloSeal hemostatic sealant in the lumpectomy cavity results in benign mammographic microcalcifications that could be misinterpreted as malignant. ..
  3. Rouach Y, Delongchamps N, Patey N, Fontaine E, Timsit M, Thiounn N, et al. Suture or hemostatic agent during laparoscopic partial nephrectomy? A randomized study using a hypertensive porcine model. Urology. 2009;73:172-7 pubmed publisher
    ..However, conventional suture of the urinary tract, when opened, should be considered. Additional evaluation in humans is required before any clinical recommendation can be made. ..
  4. Gruber H, Johnson T, Leslie K, Ingram J, Martin D, Hoelscher G, et al. Autologous intervertebral disc cell implantation: a model using Psammomys obesus, the sand rat. Spine (Phila Pa 1976). 2002;27:1626-33 pubmed
    ..Although technically challenging, the authors' experience showed that autologous disc cell implantation can be successful and that the sand rat is a valuable model for autologous disc cell studies. ..
  5. Derweesh I, Malcolm J, DiBlasio C, Mehrazin R, Jackson S. Sutureless laparoscopic heminephrectomy: safety and efficacy in physiologic and chronically obstructed porcine kidney. Surg Innov. 2008;15:194-202 pubmed publisher
    ..The procedure is reproducible, and resection/renorrhaphy was completed on average with approximately 12 minutes warm ischemia time. ..
  6. L Esperance J, Sung J, Marguet C, Maloney M, Springhart W, Preminger G, et al. Controlled survival study of the effects of Tisseel or a combination of FloSeal and Tisseel on major vascular injury and major collecting-system injury during partial nephrectomy in a porcine model. J Endourol. 2005;19:1114-21 pubmed
    ..A proposed technique for laparoscopic partial nephrectomy without reconstructive techniques is presented that warrants clinical study. ..
  7. Nasso G, Piancone F, Bonifazi R, Romano V, Visicchio G, De Filippo C, et al. Prospective, randomized clinical trial of the FloSeal matrix sealant in cardiac surgery. Ann Thorac Surg. 2009;88:1520-6 pubmed publisher
    ..We compared a hemostatic matrix sealant agent (FloSeal; Baxter Inc, Deerfield, IL) with alternative topical hemostatic agents in a mixed cohort of elective cardiac and thoracic aortic operations...
  8. Gazzeri R, Galarza M, Neroni M, Alfieri A, Esposito S. Minimal craniotomy and matrix hemostatic sealant for the treatment of spontaneous supratentorial intracerebral hemorrhage. J Neurosurg. 2009;110:939-42 pubmed publisher
    ..In this preliminary experience, a small craniotomy combined with FloSeal helped to control operative bleeding, reducing brain exposure and damage to the surrounding tissue while reducing the length of the surgery. ..
  9. Björses K, Holst J. Topical haemostatics in renal trauma--an evaluation of four different substances in an experimental setting. J Trauma. 2009;66:602-11 pubmed publisher
    ..Gelatin-containing products provided a fast hemostasis in this experimental model. One third of the animals rebled, regardless of whether thrombin or rFVIIa was added. Further studies are demanded to confirm these results clinically. ..
  10. Ahlering T, Eichel L, Chou D, Skarecky D. Feasibility study for robotic radical prostatectomy cautery-free neurovascular bundle preservation. Urology. 2005;65:994-7 pubmed
    ..The effect on potency needs further follow-up. ..
  11. Klemcke H. Evaluation of FloSeal as a potential intracavitary hemostatic agent. J Trauma. 2006;60:385-9 pubmed
  12. Shashoua A, Gill D, Barajas R, Dini M, August C, Kirschenbaum G, et al. Caseating granulomata caused by hemostatic agent posing as metastatic leiomyosarcoma. JSLS. 2009;13:226-8 pubmed
    ..Use of gelatin-thrombin hemostatic agents may elicit a foreign body reaction leading to large giant cell granulomata. In this case, the presence of these granulomata mimicked metastatic disease. ..
  13. Partsafas A, Bascom D, Jorgensen S, Wax M. Effects of Tisseel and FloSeal on primary ischemic time in a rat fasciocutaneous free flap model. Laryngoscope. 2004;114:301-4 pubmed
    ..4, 9.0, and 7.0 hours, respectively.CONCLUSIONS FloSeal, a thrombin-based hemostatic agent, and Tisseel, a fibrin glue, displayed no adverse effect on flap survival in this model. ..
  14. Yesher J, Herskowitz M, Ghosh B. Massive bleeding from duodenal carcinoid treated by gastroduodenal artery embolization. J Surg Oncol. 2002;79:199-200 pubmed
  15. Shim S, Seong J, Han K, Chon C, Suh C, Lee J. Local radiotherapy as a complement to incomplete transcatheter arterial chemoembolization in locally advanced hepatocellular carcinoma. Liver Int. 2005;25:1189-96 pubmed
    ..Therefore, RT in addition to TACE is strongly recommended for patients with an unresectable HCC. ..
  16. Siskin G, Stainken B, Dowling K, Meo P, Ahn J, Dolen E. Outpatient uterine artery embolization for symptomatic uterine fibroids: experience in 49 patients. J Vasc Interv Radiol. 2000;11:305-11 pubmed
    ..With defined telephone follow-up, staff availability, and a protocol designed to alleviate the postprocedure constitutional symptoms, uterine artery embolization is both safe and effective when performed as an outpatient procedure. ..
  17. Rontal E, Rontal M. Permanent medialization of the paralyzed vocal fold utilizing botulinum toxin and Gelfoam. J Voice. 2003;17:434-41 pubmed
    ..There were no untoward complications. All the materials used are nonpermanent. The procedure does not limit other techniques from being performed at a later time. ..
  18. Chandra R, Conley D, Haines G, Kern R. Long-term effects of FloSeal packing after endoscopic sinus surgery. Am J Rhinol. 2005;19:240-3 pubmed
    ..FS appears to be associated with scar tissue formation and may be incorporated into recovering mucosa. Use of FS may increase the degree of postoperative care required after ESS. ..
  19. Franzen A. [Myringoplasty with a soft tissue plug in cases of residual perforations after tympanoplasty]. Laryngorhinootologie. 2005;84:722-4 pubmed
  20. Lubaroff D, Konety B, Link B, Ratliff T, Madsen T, Shannon M, et al. Clinical protocol: phase I study of an adenovirus/prostate-specific antigen vaccine in men with metastatic prostate cancer. Hum Gene Ther. 2006;17:220-9 pubmed
  21. Shibata T, Sasaki Y, Imaoka S, Yasuda T, Wada H, Ishikawa O, et al. [Effectiveness of preoperative transcatheter arterial embolization for improved survival rates in patients with hepatocellular carcinomas (sandwich therapy using ethiodized oil, cisplatin and gelatin sponge]. Gan To Kagaku Ryoho. 1988;15:2514-9 pubmed
  22. Bhatia C, Barzilay Y, Krishna M, Friesem T, Pollock R. Cement leakage in percutaneous vertebroplasty: effect of preinjection gelfoam embolization. Spine (Phila Pa 1976). 2006;31:915-9 pubmed
    ..This has resulted in only limited application of vertebroplasty in the United Kingdom. Routine gelfoam embolization together with careful technique has been shown to be a safe and feasible method during vertebroplasty. ..
  23. Guan Y, Sun L, Zhou X, Li X, Fei Z, Zheng X, et al. Polyvinyl alcohol and gelatin sponge particle embolization of splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis. World J Gastroenterol. 2005;11:2684-6 pubmed
  24. Okamoto T, Yamamoto Y, Gotoh M, Huang C, Nakamura T, Shimizu Y, et al. Slow release of bone morphogenetic protein 2 from a gelatin sponge to promote regeneration of tracheal cartilage in a canine model. J Thorac Cardiovasc Surg. 2004;127:329-34 pubmed
    ..This regenerated cartilage was not reabsorbed for longer than 6 months and was strong enough to maintain the integrity of the internal lumen of the trachea. ..
  25. Bismuth H, Morino M, Sherlock D, Castaing D, Miglietta C, Cauquil P, et al. Primary treatment of hepatocellular carcinoma by arterial chemoembolization. Am J Surg. 1992;163:387-94 pubmed
    ..Improvement in survival was noted when patients who underwent chemoembolization were compared with an historical series of untreated patients, and resection and transplantation are kept as options. ..
  26. Tsatsas D, Meliou H, Kerezoudis N. Sealing effectiveness of materials used in furcation perforation in vitro. Int Dent J. 2005;55:133-41 pubmed
    ..MTA alone or Vitremer in combination with a collagen sponge can be used effectively in the treatment of perforations in a furcation area. ..
  27. Peng B, He Q, Li J, Zhou F. Adjuvant transcatheter arterial chemoembolization improves efficacy of hepatectomy for patients with hepatocellular carcinoma and portal vein tumor thrombus. Am J Surg. 2009;198:313-8 pubmed publisher
    ..9%, 33.8%, 21.5%; respectively) than the control group (33.3%, 17.0%, 8.5%, respectively; log rank P = .0094). Postoperative TACE enhances the effect of liver resection combined with PVTT removal for HCC patients with PVTT. ..
  28. Jovanovic S, Hunt D, Bernard G, Spiekermann H, Wozney J, Wikesjö U. Bone reconstruction following implantation of rhBMP-2 and guided bone regeneration in canine alveolar ridge defects. Clin Oral Implants Res. 2007;18:224-30 pubmed
    ..Combining rhBMP-2/ACS with GBR appears to be of limited value due to the potential for wound failure or persistent seromas. ..
  29. Layer G. [Radiological procedures in gastrointestinal bleeding--treatment]. Dtsch Med Wochenschr. 2003;128:2078-80 pubmed
  30. Krishnan S, Conner T, Leslie R, Stemkowski S, Shander A. Choice of hemostatic agent and hospital length of stay in cardiovascular surgery. Semin Cardiothorac Vasc Anesth. 2009;13:225-30 pubmed publisher
    ..791; P < .01). Among patients who did exceed expected LOS, FLOSEAL patients did so at a reduced rate (incidence rate ratio = 0.891; P < .01). Further assessment is warranted to distinguish products with favorable outcomes. ..
  31. Weber R. [Nasal packing after FESS--time is over?]. Laryngorhinootologie. 2009;88:379-84 pubmed publisher
    ..Occlusion of the nose via simple taping of the nasal entrance is a simple and very effective method to create a moist environment to optimize endonasal wound healing or management of a dry nose. ..
  32. Losanoff J, Basson M. Percutaneous embolization of enterocutaneous fistulas. Dis Colon Rectum. 2007;50:2003-4 pubmed
  33. Wikesjö U, Qahash M, Thomson R, Cook A, Rohrer M, Wozney J, et al. Space-providing expanded polytetrafluoroethylene devices define alveolar augmentation at dental implants induced by recombinant human bone morphogenetic protein 2 in an absorbable collagen sponge carrier. Clin Implant Dent Relat Res. 2003;5:112-23 pubmed
    ..The dental implant surface technology does not appear to substantially influence bone formation. ..
  34. Bhayani S, Grubb R, Andriole G. Use of gelatin matrix to rapidly repair diaphragmatic injury during laparoscopy. Urology. 2002;60:514 pubmed
    ..The presented case and technique should be considered in selected small diaphragmatic injuries. ..
  35. Kim H, Chung J, Jae H, Yoon J, Lee J, Kim Y, et al. Caudate lobe hepatocellular carcinoma treated with selective chemoembolization. Radiology. 2010;257:278-87 pubmed publisher
    ..278; 95% CI: 0.10, 0.76; P = .013). Selective chemoembolization via the caudate artery is possible in most patients with caudate lobe HCC and a critical factor in longer overall survival and longer progression-free survival. ..
  36. Hayashi K, Ina H, Tezuka M, Okada Y, Irie T. Local therapeutic results of computed tomography-guided transcatheter arterial chemoembolization for hepatocellular carcinoma: results of 265 tumors in 79 patients. Cardiovasc Intervent Radiol. 2007;30:1144-55 pubmed
  37. Hacker H, Schwöbel M, Allgayer B. Pseudoaneurysm rupture after liver injury in a 14-year-old boy. Eur J Pediatr Surg. 2008;18:126-8 pubmed publisher
    ..In view of this complication, we suggest carrying out colour Doppler sonographic imaging to rule out pseudoaneurysm in children with blunt hepatic trauma before they are discharged from hospital. ..
  38. Stacey M, Rampaul R, Rengaragan A, Duffy J, Macmillan R. Use of FloSeal matrix hemostatic agent in partial splenectomy after penetrating trauma. J Trauma. 2008;64:507-8 pubmed
  39. Chapman W, Lockstadt H, Singla N, Kafie F, Lawson J. Phase 2, randomized, double-blind, placebo-controlled, multicenter clinical evaluation of recombinant human thrombin in multiple surgical indications. J Thromb Haemost. 2006;4:2083-5 pubmed
  40. Akhyari P, Fedak P, Weisel R, Lee T, Verma S, Mickle D, et al. Mechanical stretch regimen enhances the formation of bioengineered autologous cardiac muscle grafts. Circulation. 2002;106:I137-42 pubmed
  41. Nugent H, Rogers C, Edelman E. Endothelial implants inhibit intimal hyperplasia after porcine angioplasty. Circ Res. 1999;84:384-91 pubmed
    ..Reduced cellular infiltration and no humoral response were detected in animals that received allografts. Despite the difference in immune response, the biological effects of xenografts or allografts did not differ significantly. ..
  42. Kang S, Yoon C, Jeong S, Kim J, Lee S, Lee K, et al. Single-session combined therapy with chemoembolization and radiofrequency ablation in hepatocellular carcinoma less than or equal to 5 cm: a preliminary study. J Vasc Interv Radiol. 2009;20:1570-7 pubmed publisher
    ..Single-session combined therapy is an effective and safe treatment for HCCs less than or equal to 5 cm. ..
  43. Renkens K, Payner T, Leipzig T, Feuer H, Morone M, Koers J, et al. A multicenter, prospective, randomized trial evaluating a new hemostatic agent for spinal surgery. Spine (Phila Pa 1976). 2001;26:1645-50 pubmed
    ..Proceed was as safe as Gelfoam-thrombin when used for hemostasis during spinal surgery procedures. ..
  44. Katsumori T, Bamba M, Kobayashi T, Moritani S, Urabe M, Nakajima K, et al. Uterine leiomyoma after embolization by means of gelatin sponge particles alone: report of a case with histopathologic features. Ann Diagn Pathol. 2002;6:307-11 pubmed
    ..The histologic and radiologic features of this case are discussed. To the best of our knowledge, this is the first reported case of uterine leiomyoma after UAE using only gelatin sponge particles as a primary embolic agent. ..
  45. Gill I, Ramani A, Spaliviero M, Xu M, Finelli A, Kaouk J, et al. Improved hemostasis during laparoscopic partial nephrectomy using gelatin matrix thrombin sealant. Urology. 2005;65:463-6 pubmed
    ..This gelatin matrix-thrombin tissue sealant is now a routine part of laparoscopic partial nephrectomy at our institution. ..
  46. Kim P, Su J, Buczkowski A, Schaeffer D, Chung S, Scudamore C, et al. Computed tomography and angiographic interventional features of ruptured hepatocellular carcinoma: pictorial essay. Can Assoc Radiol J. 2006;57:159-68 pubmed
    ..This pictorial essay reviews the radiologic features of spontaneously ruptured HCC on CT imaging and of treatment by angiography. ..
  47. Richter F, Tüllmann M, Turk I, Deger S, Roigas J, Wille A, et al. [Improvement of hemostasis in laparoscopic and open partial nephrectomy with gelatin thrombin matrix (FloSeal)]. Urologe A. 2003;42:338-46 pubmed
    ..The tissue sealant may provide a tool to expand the possibilities of laparoscopic nephron-sparing surgery. ..
  48. Griffin T, Cheung W. Treatment of gingival recession with a platelet concentrate graft: a report of two cases. Int J Periodontics Restorative Dent. 2004;24:589-95 pubmed
    ..Complete root coverage was achieved in both cases. Optimal esthetic results, with excellent soft tissue contour and texture, were observed. The patients were satisfied with the appearance. This technique warrants further investigation. ..
  49. Uçar C, Ceylan S, Gürbüz D, Savas Y, Huq G. Frontal sinus obliteration by a composite multifractured osteoperiosteal flap: a pilot study. Ann Plast Surg. 2009;63:552-5 pubmed publisher
    ..This procedure provided an anteriorly opened frontal sinus cavity, which has been filled firstly with absorbable gelatin sponge and finally covered with the CMOF...
  50. Zhou D, Zu Q. [Effects of a hemostatic jelly with polylactic acid on hemostasis of injured cancellous bone]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2006;20:511-4 pubmed
    ..The compound hemostatic jelly manifests both hemostatic and absorbable effects on injured cancellous bone and may substitute for bone wax in clinical application. ..
  51. Daley J, Brancato S, Thomay A, Reichner J, Albina J. The phenotype of murine wound macrophages. J Leukoc Biol. 2010;87:59-67 pubmed
    ..Wound macrophages exhibit a complex phenotype,which includes traits associated with alternative and classical activation and changes as the wound matures.The wound macrophage phenotype does not require IL-4 or IL-13. ..
  52. Eriksson L, Mulic Lutvica A, Jangland L, Nyman R. Massive postpartum hemorrhage treated with transcatheter arterial embolization: technical aspects and long-term effects on fertility and menstrual cycle. Acta Radiol. 2007;48:635-42 pubmed
    ..PPH after cesarean section might need to be embolized with metallic coils in addition to Gelfoam in order to achieve secure hemostasis. ..
  53. Wang Y, Hou C, Chen A. [Experimental study on the hemostatic properties of collagen sponge]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2001;15:140-3 pubmed
    ..Collagen sponge has fine hemostatic properties and can induce regeneration of hepatocytes effectively. It is worth popularizing for its convenience in clinical application and its properties of rapid degradation and absorption. ..