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The main topic of this SOC is understanding patients’ bleeding challenges, which encompass different bleeding situations, the financial impact of bleeding in surgery, hemostatic cascade, and adjunctive hemostats. 


It is essential to highlight that different bleeding situations require different solutions. Indeed, between 32% and 68% of cases in open procedures experience major bleeding events. 


The risk of surgical bleeding can be increased due to patient factors such as obesity or unhealthy habits, and medication. 


When it comes to hemostatic bleeding, there are multiple points of intervention: vessel injury, vasoconstriction, platelet plug formation, fibrin clot formation, and fibrinolysis.


There are several addressing the surgical bleeding situation with adjunctive hemostats such as continuous oozing in which the solution is oxidized regenerated cellulose. The difficulty to access situations is commonly solved with flowable gelatin and potential re-bleeding risk situations have the category solution of fibrin sealant. Finally, the problematic situations are solved with fibrin patches. 


In conclusion, the author comments on a slide with an overview of different bleeding situations and their category solutions. Moreover, Ethicon offers the most comprehensive portfolio of adjunctive hemostats.

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Dr. Matthew D. McDonald DO, FACS, FASMBS, Director of Bariatric and Minimally Invasive Surgery, Capital Bariatrics, Capital Cardiology Associates Practice, Inc, USA Bariatric Surgery
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