Hemostasis

Most serious adverse reactions-

Potentiation of infection ( including abcess formation , hematoma, wound dehiscence  and
mediastinitis ). Adhesion formation, allergic reaction, foreign body reaction, subgaleal seroma

The use of MCH in dental extraction sockets increases the incidence of alveoagia.

Closure of incisions, it may interfere with the healing of the skin adges due to simple mechanical
interposition of dry collagen

Special  Precautions-
Sterilization- MCH is inactivated by autoclaving. Ethylene oxide reacts with bound hydrochloric
acid to form ethyelene chlorohydrin.

Infection- Presence of the hemostat does not enhance or initiate experimental staphylococcus
wound nfections to a greater or lesser extent than control agents.
Use in a  contaminated wounds may enhance infection.

Excess material - remove excess material .This is usually possible without the reinitiation of
active bleeding. Faliure to remove excess material may result in bowel adhesion or mechanical
pressure sufficient to compromise the ureter.

Antibodies-  Contains a low level of intercalated bovine serum protein that reacts immunologically
as does beef serum albumin BSA. Increase in anti-BSA  titer have been observed following treatment.

Blood from operative sites- fragments of MCH may pass through filters of blood scavanging
systems. Therefore, avoid reintroduction of blood from sites treated with MCH.

Autologous blood salvage circuits- MCH should not be used in conjunction with autologous
blood salvage circuits.

Handling- avoid spilllage on nonbleeding surfaces , particularly in abdominal or thoraic viscera

Pregnancy- use only when clearly needed and when the potential benefits outweigh the potential
hazards to the fetus.

Lactation- there is no information available regarding this medication in breast-feeding women.
 

Indication-
Hemostasis

Dosage-
Fibrous form-   must be applied directly to  the source of bleeding . because of its adehesiveness with
saline or thrombin impairs its hemostatic efficacy. It should be used dry.
Discard any unused portion.

Surface preparation-  compress with dry sponges immediately prior to application of the dry product,
then apply with a dry sponge, the length of time varies with the force and severity of bleeding

Capillary bleeding- 1g is usually sufficient to a 50cm2 area. Thicker coversage is required for
more brisk bleeding. 

Pharmacology-
Microfibrillar collagen hemostat MCH is an absorbable topical hemostatic agent prepared as a
dry sterile fibrous water insoluble partial hydrochloric acid salt of purified bovine corium collagen

In contact with a bleeding surface MCH attracts platelets that adhere to the fibrils and undergo
the release phenomenon to trigger aggregation of platelet into thrombi in the interstices of the fibrin
mass.

Pregnancy-
Use only when clearly needed and when the potential benefits outweigh the potential
hazards to the fetus.

Lactation-
There is no information available regarding this medication in breast-feeding women.