Abstract
Parenchymal bleeding arising from injuries to the liver, spleen, and kidneys represents one of the most challenging types of hemorrhage to control due to its diffuse nature, absence of a clear bleeding point, and the high likelihood of coagulopathy. Despite the widespread use of mechanical hemostasis, electrocoagulation, and packing techniques, their effectiveness remains limited in deep or multifocal parenchymal injuries. Consequently, the use of topical hemostatic sponges of various types has gained increasing relevance in both emergency and elective surgery. The aim of the study is to evaluate the effectiveness of hemostatic sponges in the management of parenchymal bleeding by analyzing preclinical and clinical studies focused on different categories of topical hemostatic materials. A comprehensive review of preclinical and clinical studies, systematic reviews, and meta-analyses evaluating hemostatic sponges of animal, plant, and synthetic origin for parenchymal bleeding was conducted. Searches were performed in PubMed, MedLine, and Scopus for the period 2019-2025. A total of 213 publications were identified; 119 were excluded based on predefined criteria (duplication, insufficient level of evidence, absence of data on parenchymal organs). Ninety-four studies meeting the inclusion criteria were included in the final analysis. Most studies demonstrate that the use of topical hemostatic sponges significantly reduces the time to bleeding control, decreases intraoperative blood loss, and lowers the risk of rebleeding compared with standard hemostatic techniques. The most extensively investigated materials include collagen, gelatin, oxidized cellulose, fibrin, and chitosan-based sponges, each characterized by distinct mechanisms of action. Comparative analyses indicate that, although many types of sponges show comparable clinical effectiveness, the optimal choice depends on wound characteristics and intraoperative conditions. wide range of hemostatic sponges is currently available for the management of parenchymal bleeding; however, no universally ideal material exists. This review confirms that topical hemostatic sponges represent a justified and clinically effective adjunct to standard approaches for achieving hemostasis. Keywords:hemostatic sponges, topical hemostasis, parenchymal bleeding, collagen, gelatin, chitosan.