How do you mix Flowable Avitene?

• A. Mix Avitene flour with sterile water until a paste forms.
• B. Mix Avitene flour with saline or thrombin solution until a uniform paste forms.
• C. Mix Avitene flour with saline until crystals form.
• D. Mix Avitene flour with blood

Answer: (B)

Flowable Avitene is designed to be reconstituted into a workably flowable paste by mixing the Avitene flour with a liquid that makes it easy to apply to a bleeding surface. Using sterile saline or a thrombin solution provides the right environment and viscosity: saline keeps the mixture isotonic and tissue-friendly, helping it conform to irregular surfaces, while thrombin can speed the formation of a clot by directly activating the final step of the coagulation cascade at the site. This combination yields a uniform paste that stays where you place it and enhances hemostasis.

Mixing with sterile water isn’t preferred because it doesn’t offer the same isotonic conditions and can alter consistency, making the paste harder to apply. The idea of forming crystals isn’t applicable to Avitene in this context, since crystals aren’t the desired form for achieving a flowable paste. Mixing with blood is unsafe and inappropriate for preparing a hemostat.