What is Gelfoam, and how is it prepared and delivered?
Gelfoam is a reabsorbable gelatin that is most widely used in its sheet form. Wedges (1 to 2 mm) of Gelfoam are divided from the larger sheets. The Gelfoam can be injected as “torpedoes” through a catheter placed in a blood vessel, or the Gelfoam can be suspended in a contrast/saline slurry, which can be injected.
How does Gelfoam work, and when is it used?
Gelfoam causes vascular occlusion by mechanically obstructing vessels, serving as a matrix for thrombus formation, and causing endothelial inflammation that incites further thrombus formation. Gelfoam is reabsorbed in 5 to 6 weeks, during which time vessel recanalization is anticipated.
Clinical situations in which temporary vascular occlusion is preferred include pelvic arterial hemorrhage after trauma, priapism, peripartum hemorrhage, and some cases of upper gastrointestinal (GI) bleeding. The rationale for using Gelfoam in these situations is based on the belief that use of a temporary agent would minimize long-term ischemic effects on the end organ.