***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Vascular surgical procedures may be prolonged because of intraoperative bleeding that is not easily controlled by cautery or suture ligation . This trial compared the ability of a new hemostat , FloSealTM Matrix ( FM ) , with a known hemostat , Gelfoam ® plus thrombin ( GT ) , to control intraoperative bleeding . Patients undergoing vascular surgery procedures at four institutions were entered in the trial . After a bleeding site was identified , patients were r and omized to one of the study agents : ( 1 ) FM , a cross-linked gelatin of bovine origin combined with thrombin , or ( 2 ) GT . The assigned agent was applied and the site observed for bleeding at 1 , 2 , 3 , 6 , and 10 min . The primary end point was cessation of bleeding within 10 min for the first identified site treated . Secondary end points were cessation of bleeding within 10 min for all sites and time to cessation of bleeding . Patients were assessed for morbidity at 30 days and 6 - 8 weeks after the operation . Analysis was performed on an intent-to-treat basis for analysis of hemostasis at 10 min and on protocol -valid patients for analysis of time to hemostasis . From our results we concluded that for patients undergoing vascular surgery procedures , the new topical hemostat , FloSeal Matrix , provides more rapid and effective hemostasis than Gelfoam plus thrombin The safety and efficacy of a new hemostatic sealant , based on a gel with collagen derived particles and topical thrombin ( FloSeal , Fusion Medical Technologies , Inc. Fremont , CA ) were assessed as an alternative to nasal packing for hemostasis in functional endoscopic sinus surgery . In a prospect i ve clinical study of 50 patients undergoing bilateral endoscopic anterior ethmoidectomy  , 2 ml FloSeal was used after surgery to stop bleeding . The results were compared to a control group of 50 patients with Merocel packing  and showed that intraoperative hemostasis was rapid and equal in both groups . The main advantages of the new hemostatic sealant included a higher degree of comfort during postoperative nasal breathing and absence of complaints due to pressure or pain . There was only one case of postoperative bleeding on the 6th day , which required nasal packing . There were no more cases of stenoses or synechia in the ostiomeatal complex than were found in the Merocel group . No systemic side effects due to FloSeal were observed . This specific hemostatic sealant was shown to be a safe and efficacious alternative method for hemostasis in endoscopic sinus surgery with high patient satisfaction and an easy and fast mode of application OBJECTIVE To determine whether FloSeal Matrix Hemostatic Sealant is a safe and effective means of controlling bleeding  post-endoscopic sinus surgery ( ESS ) and to assess postoperative healing . DESIGN Prospect i ve clinical study . SETTING University of Toronto . METHODS Eighteen patients with FloSeal placed on a total of 30 operative sites post-ESS .  Time to cessation of bleeding was assessed intraoperatively . Patients had the operative sites assessed at 30 days postoperatively . MAIN OUTCOME MEASURES Effectiveness of FloSeal in controlling bleeding and aiding in healing of the operative site . RESULTS FloSeal adequately controls postoperative bleeding in patients post-ESS .  Healing was also not adversely affected . CONCLUSIONS FloSeal is a safe and effective treatment for controlling blood loss after EES . It may also provide support to the middle meatus as well as improve healing of the operative site compared with the use of traditional nasal packing . However , r and omized clinical trials are needed to further evaluate this BACKGROUND Topical hemostatic agents composed of a gelatin-based matrix and thrombin have been reported to be effective , in addition to traditional means , in terminating bleeding during cardiac operations . We compared a hemostatic matrix sealant agent ( FloSeal ; Baxter Inc , Deerfield , IL ) with alternative topical hemostatic agents in a mixed cohort of elective cardiac and thoracic aortic operations . METHODS Following sample size calculation , in a prospect i ve r and omized study design , 209 patients were treated with FloSeal matrix sealant ( FloSeal group ) and 206 patients received alternative agents as topical hemostatic material s ( comparison group ) . FloSeal is composed of a self-exp and able gelatin matrix component and purified bovine thrombin . Comparisons included hemostatic patches or sponges composed of either oxidized regenerated cellulose or purified porcine skin gelatin . Study endpoints were the following : rate of successful intraoperative hemostasis ( identified by cessation of bleeding ) and time required for hemostasis ; overall postoperative bleeding ; rate of transfusion of blood products ; rate of surgical revision for bleeding ; postoperative morbidity ; and intensive care unit stay . RESULTS Statistically higher rates of successful hemostasis and shorter time-to-hemostasis were observed in the FloSeal group ( p < 0.001 both ) . Time-to-event analysis confirmed this finding ( p = 0.0025 ) . Postoperative bleeding and rate of transfusion of blood products were statistically decreased in the FloSeal group ( p < 0.001 both ) . Rates of revision for bleeding and of minor complications were not statistically different among groups in the overall cohort , but were significantly lesser in the FloSeal group if only patients with overt intraoperative bleeding are considered ( p = 0.04 both ) . The advantages observed in the FloSeal group were not offset in patients undergoing systemic hypothermia . CONCLUSIONS The topical hemostatic agent used in the FloSeal group is effective in terminating intraoperative bleeding as an adjunct to traditional surgical methods for stopping bleeding . Its judicious use is associated with lesser need for transfusion of blood products and rate of revision for bleeding . Its cost-utility profile should be addressed in dedicated trials OBJECTIVES : To evaluate the efficacy of Floseal as a hemostatic sealant compared to traditional electrocautery hemostasis after cold knife adenotonsillectomy . STUDY DESIGN : Prospect i ve , r and omized , controlled trial of 68 consecutive patients undergoing cold steel adenotonsillectomy .  Patients were r and omized to receive either Floseal ( FS ) or electrocautery ( EC ) for hemostasis . RESULTS : FS patients had shorter operative times than EC patients ( 16 min vs 31.2 min , P < 0.0001 ) and less blood loss ( 49.2 mL vs 70.8 mL , P < 0.05 ) . Four EC patients were crossed over to Floseal when adequate hemostasis could not be achieved in the adenoid bed . No Floseal patients were crossed over . FS patients had significantly less pain on postoperative days two through 11 ( P < 0.05 ) and less use of narcotic pain medications over the first 10 postoperative days ( P < 0.05 ) . FS patients also had a faster return to regular diet ( 5.5 days vs 7.9 days , P < 0.01 ) and activity ( 5.3 days vs 7.8 days , P < 0.01 ) as compared to the EC patients . There were no significant complications in either group . CONCLUSIONS : Floseal is safe and efficacious , and decreases postoperative morbidity as compared to electrocautery hemostasis after cold steel adenotonsillectomy . SIGNIFICANCE : This study demonstrates the safety and efficacy of Floseal as a hemostatic method in children undergoing adenotonsillectomy Objectives : Purified plant polysaccharide ( HemoStase ) is a plant-derived hemostatic agent that has not previously been used in sinus surgery . This study was conducted to evaluate the effectiveness of this novel agent in the control of nasal bleeding during endoscopic sinus surgery  . The volume of bleeding during endoscopic sinus surgery was hypothesized to not be statistically significantly different between a control group ( gelatin-thrombin matrix ; FloSeal ) and an experimental group ( purified plant polysaccharide ; HemoStase ) . Methods : Eighteen patients with a history of chronic rhinosinusitis in whom maximal medical therapy failed who underwent endoscopic sinus surgery were r and omized into one of two groups ( control FloSeal group or experimental HemoStase group ) . In the control group , sites in the nose that were actively bleeding during the operation were controlled with FloSeal . In the experimental group , sites in the nose that were actively bleeding during the operation were controlled with HemoStase . The main outcome measure was total operative blood loss . Blood loss was the sum of blood removed by suction during the surgery ( recorded in milliliters ) and blood on surgical sponges ( weighed and converted to milliliters ) . Statistical analysis was performed with the t-test and the Mann-Whitney U test . Results : The amounts of blood loss ( mean ± SEM ) were not significantly different between the FloSeal ( 262 ± 15 mL ) and HemoStase ( 265 ± 33 mL ) groups ( p = 0.93 ) . Conclusions : The results of this study demonstrate the use of a novel product for the control of intraoperative bleeding during endoscopic sinus surgery Purpose : FloSeal Matrix is a new , two-component ( collagen granules and thrombin ) , topical hemostatic sealant . We prospect ively evaluated the role of FloSeal Matrix in achieving hemostasis in dacryocystorhinostomy ( DCR ) surgery and its intraoperative characteristics ( ease of use ) . We hypothesize that FloSeal will efficiently control bleeding in patients and eliminate the need for postoperative intranasal dressing . Methods : FloSeal was used during surgery in 10 consecutive patients undergoing DCR . A further 10 consecutive patients ( comparative group ) had DCR without FloSeal ; nasal packing was performed to control postoperative bleeding . The severity of postoperative bleeding and patient comfort were compared between the two groups at three time points ( immediately after surgery , 12 hours after surgery , and 24 hours after surgery ) . Results : All patients in the comparative group had some degree of postoperative bleeding ( minimal to severe ) , whereas the nine patients in the FloSeal group had none or minimal bleeding . The difference was statistically significant at all three measured time points ( p = 0.047 , 0.006 , 0.05 ) . The FloSeal group also had less postoperative discomfort ( p = 0.0001 ) . Conclusions : FloSeal Matrix is an effective hemostasis adjunct in patients undergoing lacrimal surgery . It has the added benefits of high patient satisfaction and ease of use OBJECTIVE To evaluate the hemostatic efficacy and h and ling of gelatin-thrombin matrix in abdominal myomectomy . DESIGN Prospect i ve and r and omized trial . SETTING University teaching hospital . PATIENT(S ) Women ( n = 50 ) with uterine fibroids with a uterine size equivalent to > or = 16 weeks gestation . INTERVENTION(S ) Gelatin-thrombin matrix ( FloSeal Matrix ; Baxter Healthcare Corp. , Fremont , CA ) was delivered to the site of the uterine bleeding during myomectomy . MAIN OUTCOME MEASURE(S ) Patient age , parity , number of myomas , operative time , blood loss , transfusion , intraoperative and postoperative complications , and length of hospitalization were evaluated . RESULT ( S ) The average blood loss during surgery was 80 + /- 25.5 mL for the FloSeal group and 625 + /- 120.5 mL for the control group . Intraoperative blood transfusion was necessary in five patients from the control group . Postoperative blood loss was 25 + /- 5 mL for the FloSeal group and 250 + /- 75 mL for the control group . Length of the postoperative hospital stay was 2.5 + /- 1.2 days for FloSeal group and 4.5 + /- 1.3 for the control group . No major immediate or delayed complications were observed in either group . CONCLUSION ( S ) Reductions in hemorrhage in FloSeal-treated women undergoing a myomectomy are encouraging , and provide evidence for the ability of gelatin-thrombin matrix to reduce blood loss when applied immediately and directly to bleeding uterine tissue Background 30 patients , with T1 renal cell carcinomas ( RCC ) who underwent open enucleoresection of the tumour , were r and omized to the use of a topical haemostatic agent ( Floseal ) or to an infrared-sapphire coagulator ( ISC ) , to compare their efficacy in achieving haemostasis . Methods : Successful intra-operative haemostasis , intra- and post-operative bleeding , operative time , hospital discharge were evaluated . Results Statistically higher rates of successful haemostasis and shorter time-to-haemostasis ( 8,1 vs 12,9 min ) were observed in the FloSeal group ( p < 0.001 both ) . Patients operative time was not different between Group 1 vs 2 ( 58.7 ± 12 vs 62.4 ± 15 ; p > 0.05 ) . The average blood loss during surgery was less ( 60 + /- 25.5 mL ) for the FloSeal group than for the ISC group ( 85 + /- 40.5 mL ) ( p < 0.05 ) . Postoperative blood loss was 25 + /- 5 mL and 40 + /- 45 mL for Floseal and ISC respectively , ( p < 0.05 ) . Length of the postoperative hospital discharge was 2.5 + /- 1.2 days for FloSeal group and 3.5 + /- 1.3 for the Group  
    Output:
    
FloSeal ® has been demonstrated to be an efficacious method in surgical procedures to reduce the time to achieve haemostasis , the frequency of intra- and postoperative bleeding , and the length of hospital stay , among other primary outcomes , result ing in less consumption of health re sources .
Conclusions The majority of the selected studies confirmed that Floseal ® showed improvements over other haemostatic agents in achieving haemostasis and reducing blood loss