Antibacterial Activity of Some Commonly Used Hemostatic Agents in Maxillofacial Surgery

Hesham Khalil*

*Department of Maxillofacial Surgery, College of Dentistry, King Saud University, Saudi Arabia.

DOI : http://dx.doi.org/10.13005/bbra/1100

ABSTRACT: After having been approved over the last few years, a variety of topical hemostatic agents are now commonly used in surgery. Hemostatic agents are used in oral and maxillofacial surgery in order to control bleeding; they can influence a surgical wound as a result of both their physical or chemical properties. The choice of any one of these agents depends varies according to a number of factors, including the surgeon’s preference and experience. The aim of the study described here was to evaluate and compare the antibacterial activity of the following hemostatic agents: absorbable gelatin, aluminum chloride, oxidized cellulose, thrombin andferric sulfate), all of which are used in oral and maxillofacial surgery to control bleeding. The antibacterial effect of the five hemostatic agents was tested against five bacteria namely: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus mutans, Streptococcus salivaris and Enterococcus faecalis. TheBrain Heart Infusion agar well diffusion assay test was used to examine the antibacterial activity of the individual hemostatic agents. After incubation, the agar plates were examined for inhibition zones, which when present were measured in millimeters. When antibacterial activity was observed, the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of the tested agents werealso determined. Three of the tested hemostatic agents (Surgicel, Viscostst and Hemox A) showed antibacterial activity against all tested organisms. Absorbable gelatin and TachoSil however, did not inhibit the growth of any of the tested bacteria. The largest inhibition zones were produced by Hemox A, while Surgicel showed the smallest inhibition zones which ranged from 20-22 mm. Differences in the size of inhibition zones produced by Surgicel, Viscostat and Hemox A were statistically significant. The minimum inhibitory and bactericidal concentrations also varied between the three effective hemostatic agents. Hemox A was the most effective agent against tested bacteria followed by Viscostat and Surgicel. Since site infections continue to be a risk of surgical failure, the antibacterial properties of hemostatic agent should be considered when selecting such materials for the control of bleeding in maxillofacial surgery.

KEYWORDS: Antibacterial activity; Hemostatic agents; infection; Maxillofacial

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