Abstract
Oxidized regenerated cellulose (ORC) has been used as an absorbable hemostat since World War II. In the present study, hemostasis time was determined in a spleen incision model in swine. The effect of mass on absorbable hemostat efficacy and hemostasis time was evaluated by standardizing the ORC materials on a mass basis. The median hemostasis time for a single layer of the new nonwoven ORC was as much as 51 % shorter than woven ORC (P < 0.001). The mean hemostasis time for nonwoven ORC was not affected by the mass of hemostat applied to the wound. The hemostatic efficacy of woven ORC increased with the mass (layers) of hemostat applied to the wound. Nonwoven ORC is significantly faster in achieving hemostasis than woven ORC, and its hemostatic efficacy is not influenced by the mass of material applied. Tissue reaction was minimal and the material was fully absorbed by 14 days.
Similar content being viewed by others
References
Abou-Elela A, Morsy A, Badawy H, Fathy M (2009) (2009) Use of oxidized cellulose hemostats (Surgicel®) to support parenchymal closure and achieve hemostasis following partial nephrectomy. Surg Technol Int 18:75–79
Awonuga AO, Merhi ZO, Khulpateea N (2006) Abdominal packing for intractable obstetrical and gynecologic hemorrhage. Int J Gynaecol Obstet 93:160–163
Bassetto F, Vindigni V, Scarpa C, Botti C, Botti G (2008) Use of oxidized regenerated cellulose to stop bleeding after a facelift procedure. Aesthetic Plast Surg 32:807–809
Bhatnagar RK, Berry S (2004) Selective Surgicel packing for the treatment of posterior epistaxis. Ear Nose Throat J 83:633–634
Bollens R, Rosenblatt A, Espinoza BP, De Groote A, Quackels T, Roumeguere T et al (2007) Laparoscopic partial nephrectomy with “on-demand” clamping reduces warm ischemia time. Eur Urol 52:804–809
Breda A, Stepanian SV, Lam JS, Liao JC, Gill IS, Colombo JR et al (2007) Use of haemostatic agents and glues during laparoscopic partial nephrectomy: a multi-institutional survey from the United States and Europe of 1347 cases. Eur Urol 52:798–803
Cronkite EP, Deaver JM, Lozner EL (1944) Experiences with use of thrombin with and without soluble cellulose for local hemostasis, War Medicine V5 p. 80–82
Davidson BR, Burnett S, Javed MS, Seifalian A, Moore D, Doctor N (2000) Experimental study of a novel fibrin sealant for achieving haemostasis following partial hepatectomy. Br J Surg 87:790–795
Dimitrijevich D, Tatarko M, Gracy RW (1990a) Biodegradation of oxidized regenerated cellulose. Carbohydr Res 195:247–256
Dimitrijevich SD, Tatarko M, Gracy RW, Wise GE, Oakford LX (1990b) In vivo degradation of oxidized, regenerated cellulose. Carbohydr Res 198:331–341
Dineen P (1976) Antibacterial activity of oxidized regenerated cellulose. Surg Gynecol Obstet 142:481–486
Dineen P (1977a) The effect of oxidized regenerated cellulose on experimental intravascular infection. Surgery 82:576–579
Dineen P (1977b) The effect of oxidized regenerated cellulose on experimental infected splenotomies. J Surg Res 23:114–116
Franz VK, Clarke HT, Lattes R (1944) Hemostasis with Absorbable Gauze (Oxidized Cellulose), Annals of Surgery p. 181–198
Gabay M (2006) Absorbable hemostatic agents. Am J Health-Syst Pharm 63:1244–1253
Hanks JB, Kjaergard HK, Hollingsbee DA (2003) A comparison of the haemostatic effect of Vivostat® patient-derived fibrin sealant with oxidised cellulose (Surgicel®) in multiple surgical procedures. Eur Surg Res 35:439–444
ISO (2007) ISO 10993–6 Biological evaluation of medical devices. Tests for local effects after implantation. International Organization for Standardization, Geneva
Johnson and Johnson (2007), Prescribing Information, Surgicel Original, Surgicel Nu-Knit and Surgicel Fibrillar absorbable hemostats (oxidized regenerated cellulose). Johnson and Johnson Wound Management, a Division of Ethicon, Inc, Somerville
Kheirabadi BS, Field-Ridley A, Pearson R, MacPhee M, Drohan W, Tuthill D (2002) Comparative study of the efficacy of the common topical hemostatic agents with fibrin sealant in a rabbit aortic anastomosis model. J Surg Res 106:99–107
Kuchta N, Dineen P (1983) Effects of absorbable hemostats on intraabdominal sepsis. Infect in Surg 2:441–444
Mair H, Kaczmarek I, Oberhoffer M, Groetzner J, Daebritz S, Reichart B (2005) Surgicel Nu-Knit hemostat for bleeding control of fragile sternum. J Thorac Cardiovasc Surg 130:605–606
Press National Academy (1996) Guide for the care and use of laboratory animals. Institute for Laboratory Animal Research (ILAR). National Academy Press, Washington
Putnam TJ (1943) The use of thrombin on soluble cellulose in neurosurgery. Ann Surg 118:127–130
Rastogi V, Dy V (2002) Control of port-site bleeding from smaller incisions after laparoscopic cholecystectomy surgery: a new, innovative, and easier technique. Surg Laparosc Endosc Percutan Tech 12:224–226
Sabel M, Stummer W (2004) Haemostasis in spine surgery. The use of local agents: surgicel and Surgifoam. Eur Spine J 13(suppl 1):S97–S101
Schwartz M, Madariaga J, Hirose R, Shaver TR, Sher L, Chari R (2004) Comparison of a new fibrin sealant with standard topical hemostatic agents. Arch Surg 139:1148–1154
Sharma JB, Malhotra M (2006) Successful management of uterine incision hemorrhage in caesarean section with topical oxidized regenerated cellulose (Surgicel Nu Nnit): a case report. Arch Gynecol Obstet 274:115–116
Sharma JB, Malhotra M, Pundir P (2003) Laparoscopic oxidized cellulose (Surgicel) application for small uterine perforations. Int J Gynaecol Obstet 83:271–275
Shinkwin CA, Beasley N, Simo R, Rushton L, Jones NS (1996) Evaluation of Surgicel Nu-knit, Merocel and Vasolene gauze nasal packs: a randomized trial. Rhinology 34:41–43
Spangler D, Rothenburger S, Nguyen K, Jampani H, Weiss S, Bhende S (2003) In vitro antimicrobial activity of oxidized regenerated cellulose against antibiotic-resistant microorganisms. Surg Infect (Larchmt) 4:255–262
Stillwell L, Marks MG, Safertsein L, Wiseman DM (1997) Oxidized cellulose: chemistry, processing and medical applications. In: Domb AJ, Kost J, Wiseman DM (eds) Handbook of biodegradable polymers. Harwood Academic Publishers, Amsterdam, pp 291–306
Theuer CP, Imagawa DK (1999) Use of knitted oxidized cellulose (Nu-knit) for the definitive packing of grade III liver fracture. Injury 30:137–140
Trooskin SZ, Flancbaum L, Boyarsky AH, Greco RS (1989) A simplified approach to techniques of splenic salvage. Surg Gynecol Obstet 168:546–548
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hutchinson, R.W., George, K., Johns, D. et al. Hemostatic efficacy and tissue reaction of oxidized regenerated cellulose hemostats. Cellulose 20, 537–545 (2013). https://doi.org/10.1007/s10570-012-9828-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10570-012-9828-8