New absorbable hemostatic agents.

2ITH the end of combat in World War II the new hemostatic agents developed in various research laboratories, developed under the pressure of the emergency, were almost ready for general surgical use. The preliminary 5isesesas~srsW experimental work had been done, clinical investigation had confirmed the laboratory reports and enough observers in general and special fields of surgery had tested the materials to appreciate the possibilities of a new technique for checking hemorrhage. The clinical investigation already done included trial by military surgeons, both British and American, in several theaters of operation. Fortunately, the carnage ceased earlier than some of us had dared hope, and before complete comparative studies of the different agents could be made in combat zones. In civilian surgery, critical evaluation of these new agents may take somewhat longer, as hemorrhage which makes packing mandatory is, happily, less commonly encountered in peace than in war. The novelty of these agents, stressed in the title of this presentation, may be questioned. The need for staunching of blood goes back beyond history and many techniques have been tried, discarded, tried again and accepted. As an example of the aphorism that there is nothing new under the sun, it should be recalled that in i9ii Cushing, who, as a neurosurgeon needs must be, was pre-occupied with hemostasis, not only advocated the use of muscle to accelerate clotting, thus anticipating thrombin, but also predicted that "fibrin from whipped blood might be so prepared that it could be immediately plastered on bleeding surfaces" -which is just the application of fibrin foam. As to another "new" agent, oxidized cellulose, it may be that Halsted* encountered its fore-