Haemostatic Powder: A Reliable Solution for Surgical Bleeding Management

Haemostatic powder

Haemorrhage, the sudden and severe leakage of blood due to blood vessel disruption, remains a leading cause of death from injuries worldwide. It accounts for over 35% of pre-hospital deaths and nearly 40% of deaths within 24 hours of injury [1]. Managing bleeding from vital organs such as the kidney, brain, and liver, as well as controlling persistent oozing over broad surfaces, presents a significant challenge in surgical procedures.

While conventional methods like suturing or ligation help in controlling bleeding, they are often insufficient in cases of diffuse or inaccessible bleeding, leading to surgical delays and increased risks. Traditionally, surgical haemostats like gauze pads impregnated with agents such as ferric chloride or thrombin have been used [2]. However, these methods have drawbacks, including the risk of disrupting blood clots during removal and causing re-bleeding. This has created a need for a more efficient, easy-to-use solution—enter haemostatic powder.

What is Haemostatic Powder?

Haemostatic powder is a reliable surgical haemostat that effectively controls bleeding by accelerating clot formation. It is gaining popularity among surgeons due to its ease of application, versatility, and ability to minimize surgical interventions [3]. Unlike traditional haemostatic agents, haemostatic powder offers a quick and reliable way to control oozing and diffuse bleeding, especially in endoscopic, or laparoscopic surgeries.

Why Haemostatic Powder is a Surgeon’s Best Ally

Surgeons rely on various haemostatic agents, including:

• Mechanical agents (e.g., gauze, sponges)

• Active agents with thrombin

• Flowable haemostats

• Sealants (e.g., fibrin or synthetic polymers)

However, haemostatic powder stands out for several reasons:

• Rapid and effective bleeding control – works within 2 minutes to stop bleeding.

• Ease of application – can be sprayed directly over large or irregular surfaces.

• Ideal for minimally invasive procedures: in laparoscopic and endoscopic surgeries, powders can be sprayed onto bleeding sites, eliminating the need for complex surgical techniques such as manual compression or suturing

• Efficient absorption: they are often absorbed naturally by the body within a few days, reducing the risk of foreign body reactions.

• Prevents re-bleeding – no need for removal, minimizing disruption of the clot and ensuring sustained haemostasis.

Advancements in Haemostatic Powder Delivery

Initially, haemostatic powder was delivered via catheters through an endoscope’s working channel. However, this method led to clogging issues due to premature coagulation upon contact with blood [4]. To overcome this, modern laparoscopic and endoscopic applicators now provide controlled and precise delivery, ensuring uniform distribution while minimizing dispersion into unintended areas [5].

Expanding the Potential of Haemostatic Powder

With continuous developments in haemostatic agents, new formulations and delivery systems have been designed to enhance effectiveness, ease of use, and surgical outcomes. Among these advancements, some of the most notable products include:

1. SURGISPON® Absorbable Haemostatic Powder

One of the leading haemostatic powders is SURGISPON® Absorbable Haemostatic Powder, a gelatin-based natural polymer that achieves rapid haemostasis within 2 minutes. It comes prefilled in a bellow bottle and sterile applicator, making it ideal for hard-to-reach surgical areas. Sterile applicators are available in two lengths (14 cm and 38 cm) and are designed for delivering Absorbable Haemostatic Powder to bleeding surgical sites during open, endoscopic, or laparoscopic procedures. The 14 cm applicator is suitable for both open and minimally invasive surgeries, while the 38 cm applicator is specifically designed for minimally invasive procedures.

2. SURGISPON® Putty

SURGISPON® Putty can be applied dry or mixed with saline to form a paste. It can be applied manually or with a syringe, allowing different consistencies and viscosities based on the surgical need. It is highly effective for irregular structures such as bones, cavities, or fissures.

Surgi-ORC® Powder

Surgi-ORC® Powder is a plant-based absorbable haemostat made from oxidized regenerated cellulose (ORC). It is specifically designed for faster control of continuous bleeding across broad surfaces and is suitable for open endoscopic, or laparoscopic surgical procedures.

Prefilled in a bellow bottle/applicator, it can be dispensed directly onto the bleeding site, offering effective control of capillary, venous, and small arterial bleeding. Surgi-ORC® Powder is white with a pale-yellow color and has a faint, caramel-like aroma and is fully absorbable.

SURGI-Powder Applicator™

Sterile applicators are available in two lengths (14 cm and 38 cm) and are designed for delivering Absorbable Haemostatic Powder to bleeding surgical sites during open, endoscopic or laparoscopic procedures. The 14 cm applicator is suitable for both open and minimally invasive surgeries, while the 38 cm applicator is specifically designed for minimally invasive procedures.

Clinical evidence

A multicenter study evaluating Surgi-ORC® Powder (Aegis Lifesciences Pvt. Ltd.) confirmed its safety and efficacy in orthopaedic surgeries. The study, conducted on 59 patients, reported 100% haemostasis within 5 minutes, with clot formation occurring within 0.83 to 1.08 minutes for Surgi-ORC® Powder in case of axial skeleton, lower limbs, and upper limbs respectively. The 60-day follow-up showed no infections, adverse events, or complications, and complete absorption was confirmed by day two [6]. Surgeons highlighted its ease of application and excellent tissue adherence, making it an ideal solution for surgical bleeding control.

Conclusion

Haemostatic powder has revolutionized surgical bleeding management, providing a fast, efficient, and minimally invasive alternative to traditional methods. With proven clinical efficacy and ease of use, products like SURGISPON® and Surgi-ORC® Powder ensure safer, more efficient procedures. As the demand for minimally invasive and precision-based surgical techniques continues to grow, haemostatic powder will remain a crucial tool in achieving optimal patient outcomes and surgical success.

References

1. Jones AR, Frazier SK. Increased mortality in adult patients with trauma transfused with blood components compared with whole blood. Journal of Trauma Nursing| JTN. 2014 Jan 1;21(1):22-9.

2. Broadnax Jr CH, inventor; Johnson, Johnson Products Inc, assignee. Surgical hemostat comprising oxidized cellulose. United States patent US 4,626,253. 1986 Dec 2.

3. MacDonald MH, Tasse L, Wang D, Zhang G, De Leon H, Kocharian R. Evaluation of the hemostatic efficacy of two powdered topical absorbable hemostats using a porcine liver abrasion model of mild to moderate bleeding. Journal of Investigative Surgery. 2021 Nov 1;34(11):1198-206.

4. Paoluzi OA, Troncone E, De Cristofaro E, Sibilia M, Monteleone G, Del Vecchio Blanco G. Hemostatic Powders in Non-Variceal Upper Gastrointestinal Bleeding: The Open Questions. Medicina (Kaunas). 2023;59(1).

5. https://public4.pagefreezer.com/content/FDA/08-02 2022T03:01/https:/www.fda.gov/media/126218/download

6. Patel P, Sharma D, Trivedi B, Karatela S. Real-world evaluation of the safety and efficacy of Surgi-ORC® in orthopedic surgeries: A multicenter prospective study. Cureus. 2025 Feb 6;17(2).