Use of Topical Hemostatic Agents in a Gynecologic Patient With Coagulopathy

This case illustrates special considerations for intraoperative topical hemostatic agent use for gynecologic patients taking chemoprophylaxis for history of thrombosis and the value of the material composition for timely activity. Fibrin sealants have more rapid hemostasis than an oxidized regenerated dry matrix of cellulose. Because of the proximity of the reproductive organs to the bladder and urinary system, procedures complicated by cystotomy may result in mild leakage of sanguineous urine. This leakage can reduce the efficacy of combined gelatin-thrombin spray by disrupting its chemical components, compared with other hemostatic agents.