Topical use of recombinant human thrombin for operative hemostasis

Abstract

Background: The topical use of thrombin has a long history in surgery as an adjunct for achieving operative hemostasis. Until recently the majority of thrombin used topically was derived from bovine plasma. This preparation has been proven to be immunogenic and has led to safety concerns in recent years. Recombinant human thrombin (rhThrombin) has recently been developed as an alternative for topical use for surgical hemostasis. Objective: To review the clinical safety and efficacy data relating to rhThrombin using bovine-derived thrombin as a comparative standard. Methods: This review summaries recent literature regarding topical use of rhThrombin using bovine thrombin as the ‘gold standard’ for topical surgical hemostasis. Conclusions: The data indicates that topical rhThrombin is as effective as bovine thrombin for hemostasis and significantly less immunogenic.

Keywords::

• antithrombin antibodies
• hemostasis
• recombinant human thrombin
• thrombin