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Li B, Pan W, Sun X, Qin K, Bai G, Bao H, Huang Y, Ma J. Hemostatic effect and safety evaluation of oxidized regenerated cellulose in total knee arthroplasty- a randomized controlledtrial. BMC Musculoskelet Disord 2023; 24:797. [PMID: 37805527 PMCID: PMC10559430 DOI: 10.1186/s12891-023-06932-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 09/29/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Oxidized regenerated cellulose (ORC) is a type of biodegradable hemostatic material, which has been widely used in the field of surgery. However, its hemostatic effect in patients undergoing total knee arthroplasty (TKA) is uncertain. Accordingly, this study investigated the effectiveness and safety of ORC in patients receiving TKA. METHODS Seventy patients undergoing unilateral TKA were randomized into blank control group and ORC (2 pieces of ORC placed in the joint cavity) groups. Then, the two groups were compared for primary (perioperative blood loss [total blood loss, intraoperative blood loss, and hidden blood loss] and hemoglobin drop values) and secondary (coagulation indicators, inflammatory indicators,operation time, and complication rates) outcomes. RESULTS The total blood loss in the ORC group was 902.32 ± 307.82 mL, which was statistically significantly lower than that in the control group (1052.25 ± 308.44 mL) (P < 0.05). Postoperative hidden blood loss was also statistically markedly lower in the ORC group (801.61 ± 298.80 mL) than in the control group (949.96 ± 297.59 mL) (P < 0.05). There was no significant difference between the two groups in terms of coagulation indicators, inflammatory indicators, operation time, and complication rates. CONCLUSION In conclusion, our prospective RCT study proved that regenerated oxidized cellulose can be used safely in vivo and can effectively reduce postoperative blood loss in patients, which is a potential method for preventing blood loss after TKA. TRIAL REGISTRATION This prospective RCT was reviewed and approved by the Ethics Committee of Honghui Hospital of Xi'an Jiaotong University (No: 202,211,007) and was designed and conducted according to the rules of the Declaration of Helsinki. Written informed consent was obtained from patients or their legal guardians.
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Affiliation(s)
- Bowei Li
- Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, 555 East Friendship Road, South Gate, Xi'an, 710054, Shaanxi Province, China
- Xi'an Medical University, Xi'an, 710068, Shaanxi Province, China
| | - Wenjie Pan
- Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, 555 East Friendship Road, South Gate, Xi'an, 710054, Shaanxi Province, China
| | - Xiaobo Sun
- Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, 555 East Friendship Road, South Gate, Xi'an, 710054, Shaanxi Province, China
| | - Kai Qin
- Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, 555 East Friendship Road, South Gate, Xi'an, 710054, Shaanxi Province, China
| | - Guoyang Bai
- Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, 555 East Friendship Road, South Gate, Xi'an, 710054, Shaanxi Province, China
| | - Huanli Bao
- Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, 555 East Friendship Road, South Gate, Xi'an, 710054, Shaanxi Province, China
| | - Yuanchi Huang
- Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, 555 East Friendship Road, South Gate, Xi'an, 710054, Shaanxi Province, China.
| | - Jianbing Ma
- Department of Knee Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, 555 East Friendship Road, South Gate, Xi'an, 710054, Shaanxi Province, China.
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MacDonald MH, Tasse L, Wang D, Zhang G, De Leon H, Kocharian R. Evaluation of the Hemostatic Efficacy of Two Powdered Topical Absorbable Hemostats Using a Porcine Liver Abrasion Model of Mild to Moderate Bleeding. J INVEST SURG 2020; 34:1198-1206. [PMID: 32928005 DOI: 10.1080/08941939.2020.1792007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Topical hemostatic agents, used alone or in combination, have become common adjuncts to manage tissue and organ bleeding resulting from trauma and surgical procedures. Oxidized regenerated cellulose (ORC) is one of the most commonly used adjunctive hemostatic agents. The aim of the present study was to compare the hemostatic efficacy of a novel ORC-based product, SURGICEL® Powder Absorbable Hemostat (Surgicel-P) to that of HEMOBLAST™ Bellows (Hemoblast-B), a collagen-based combination powder. METHODS Using an established porcine liver abrasion model, we randomly tested Surgicel-P and Hemoblast-B in 60 experimental lesion sites (30 per product tested). Primary endpoints included hemostatic efficacy measured by absolute time to hemostasis (TTH) within 5 minutes. We also examined number of applications required to achieve hemostasis, and sustained hemostasis following saline irrigation of test sites that achieved hemostasis. RESULTS Surgicel-P demonstrated significantly higher hemostatic efficacy and lower TTH (p < 0.01) than Hemoblast-B. Surgicel-P-treated lesion sites achieved hemostasis in 73.3% of cases following one product application vs. 3.3% of Hemoblast-B-treated sites. Of all sites that were assessed, hemostasis was achieved and sustained following irrigation at 93.3% of Surgicel-P-treated sites vs. 50.0% of Hemoblast-B-treated sites. The average number of Surgicel-P applications per site was 51% lower than the average number of applications used for Hemoblast-B. CONCLUSION Surgicel-P provided more effective and sustained hemostasis and faster TTH than Hemoblast-B. Surgicel-P represents a novel clinical alternative to provide adjunctive control of diffuse mild and moderate bleeding. Surgicel-P combines an ORC powder formulation and a delivery system in a device that is particularly useful for application on large surfaces and difficult-to-access anatomical locations where application of other forms of topical hemostats may be impractical.
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Affiliation(s)
| | | | - Daidong Wang
- Cardiovascular and Specialty Solutions (CSS), Irvine, California, USA
| | - Gary Zhang
- Ethicon, Inc, Johnson & Johnson, Somerville, New Jersey, USA
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