Which hemostatic agent must always be handled dry?

The appropriate hemostatic agent that must always be handled dry is microfibrillar collagen, commonly known as Avitene. This agent is specifically designed to promote hemostasis by providing a scaffold that fosters platelet aggregation and clot formation when it is in a dry state.

When Avitene is wet or moist, it can lose its ability to effectively support platelet adherence and aggregation, which can impede the clotting process. For this reason, strict attention must be paid to ensuring that it is applied in a dry form during surgical procedures to maximize its efficacy.

Understanding the characteristics of different hemostatic agents is crucial in surgical settings. Other agents mentioned, such as prothrombin/thrombin, gelatin sponge/gelfoam, and bone wax, have varying handling requirements and applications. For instance, thrombin can be used in moist environments, gelatin sponges can be hydrated for use, and bone wax is typically molded in hand before application but does not have the same stringent dry requirement as Avitene.