hemostatic

Hemostatic refers to substances, methods, or processes that stop bleeding. In medicine, hemostatic strategies aim to achieve hemostasis—the arrest of hemorrhage—after a blood vessel injury, while minimizing tissue damage and infection risk.

Hemostasis is a staged process. Vascular injury causes vasoconstriction, followed by platelet adhesion and aggregation to form a temporary plug. The coagulation cascade activates, producing fibrin to stabilize the plug into a more durable clot. Wound healing proceeds as the clot is reabsorbed or remodeled, with fibrinolysis eventually resolving the clot when the vessel repair is complete.

Hemostatic approaches include mechanical and chemical options. Mechanical methods involve direct pressure, tourniquets, or suturing to control bleeding. Topical hemostats are applied at the injury site and include absorbable materials such as gelatin sponge, oxidized regenerated cellulose, and microfibrillar collagen, as well as fibrin sealants that provide a fibrin clot. Thrombin-based products promote rapid clot formation. Hemostatic powders and pastes may be used for rapid control of oozing or diffuse bleeding. Systemic antifibrinolytics, such as tranexamic acid, reduce bleeding by inhibiting clot breakdown and may be used orally, intravenously, or topically in some settings.

Applications span surgery, dentistry, emergency medicine, trauma care, and military medicine. Hemostatic agents are chosen to balance rapid bleeding control with tissue compatibility, infection risk, and potential thrombosis. Safety considerations include the possibility of thromboembolism, impaired wound healing, and allergic reactions. Some older zeolite-based products could generate heat during activation, a drawback mitigated by modern formulations. Overall, hemostatic strategies are integral to reducing blood loss and improving patient outcomes in bleeding emergencies.