A review of topical hemostatic agents for use in cardiac surgery.

Postoperative hemorrhage, redo sternotomy for bleeding, and transfusion of blood products are all associated with poorer outcomes in cardiac surgery. Topical hemostatic agents are important adjuncts to reduce blood loss after cardiac surgery and can have a role in reducing both "surgical" and "nonsurgical bleeding." There are many topical hemostatic agents to choose from, and with several new products in this field being approved for use in the last few years, the aim of this review is to appraise these agents and to look at the evidence for their efficacy.