• Juan Leonardo Serrato-Avila, José Omar Navarro-Fernández, Rodrigo Hernández-Reséndiz, Bernardo Cacho-Díaz, Gervith Reyes-Soto, and Alejandro Monroy-Sosa.
• Department of Neurosurgery, National Medical Center 20 of November, ISSSTE, Mexico City, Mexico. Electronic address: jls_avila@hotmail.com.
• World Neurosurg. 2019 Feb 1; 122: 224-228.

ObjectiveTo present an alternative cost-effective hemostatic agent (HA) for cranial surgery and to describe the technique to produce it.MethodsThis HA has been used in 3 reference centers over the last year during 230 procedures, including different types of pathology, such as skull base, oncology, vascular, and trauma, either for endoscopic or open approaches. This agent was made from a low-cost and worldwide-available gelatin foam which was mixed with saline solution in 2 syringes and connected by a 3-way stopcock, making a useful hemostatic paste.ResultsThe cost was 16 and 28 times less than SURGIFLO and FLOSEAL, respectively. The mean time to prepare the mix was 4 minutes. It was very effective for venous and low-flow bleeding.ConclusionsThe presented technique offers a reliable and cost-effective way of achieving hemostasis in cranial surgery, therefore allowing hospitals with limited resources to perform advanced procedures in a safer way.Copyright © 2018 Elsevier Inc. All rights reserved.

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