
Use of Feracrylum in controlling Post operative Adeno-Tonsillectomy Bleeding
Good haemostasis has a very important place in any surgical procedures especially in surgery like tonsillectomy and adenoidectomy. Proper haemostasis can lead to a clean field of exposure, low blood loss .This is important in children with low blood volume. Any ENT surgeon doing Ts and Ads operation is familiar with troublesome ooze while operating causing concern.
After removing Tonsil or adenoid, the tonsil fossa or the nasopharynx is packed with sterile gauze soaked in 1% Feracrylum and kept there for five minutes, this achieve considerable haemostasis and control bothersome bleeding. Minor ooze in patients on low dose aspirin or cloplet (even after stopping) undergoing surgery can also be benefited by the use of locally applied Feracrylum.
1% Feracrylum solution is an aqueous solution of an incomplete Iron Salt of Poly Acrylic acid with haemostatic, antibacterial and hygroscopic properties.
Within a pH range of 2.9 – 4, it forms water-insoluble complexes with proteins of various origins, including those contained in blood plasma. It is available as 1% aqueous solution which is a transparent, pinkish, odorless liquid with a sour taste. It can be sterilized at 120 degrees and 1.5 atm. and is stable in storage in this form for 2 years and more.
It is safe in children and can be used in patients with blood clotting disorders such anemia, and hemophilia. Due to its high molecular weight it is not absorbed into the systemic circulation and hence does not affect the functioning of any organ such as liver or kidney. Most importantly, it does not display any rebound bleeding or effect the healing process.
In conclusion, I noticed that Feracrylum has a significant role to play in all ENT surgeries as it reduces the post operative ooze.
Nasal bleeding
The haemostatic properties of Feracrylum can be utilized in Nasal surgery too and control of Epistaxis by putting gauze soaked in Feracrylum gel.