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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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Shokrani H, Shokrani A, Seidi F, Munir MT, Rabiee N, Fatahi Y, Kucinska-Lipka J, Saeb MR. Biomedical engineering of polysaccharide-based tissue adhesives: Recent advances and future direction. Carbohydr Polym 2022; 295:119787. [DOI: 10.1016/j.carbpol.2022.119787] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/01/2022] [Accepted: 06/23/2022] [Indexed: 12/28/2022]
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The efficacy of oxidized regenerated cellulose (SurgiGuard®) in breast cancer patients who undergo total mastectomy with node surgery: A prospective randomized study in 94 patients. PLoS One 2022; 17:e0267694. [PMID: 35622779 PMCID: PMC9140258 DOI: 10.1371/journal.pone.0267694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/11/2022] [Indexed: 11/30/2022] Open
Abstract
Background Seromas frequently develop in patients who undergo total mastectomy with node surgery. We aimed to prospectively explore whether use of oxidized regenerated cellulose (ORC, SurgiGuard®) affects seroma formation after total mastectomy with node surgery (sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND)). Materials and methods Ninety four breast cancer patients were enrolled in the study who underwent total mastectomy with ALND or SLNB. The patients were randomized into two groups, one treated with ORC plus closed suction drainage and the other with closed suction drainage alone. Results Mean drainage volume was slightly lower in the ORC group on postoperative day 1 (123 ± 54 vs 143 ± 104 ml), but was slightly higher at all other time points; however, these differences were not significant. Mean total drainage volume in patients treated with ORC plus drainage did not differ from that of patients treated with drainage alone (1134 ± 507 ml vs 1033 ± 643 ml, P = 0.486). Conclusions Use of ORC (SurgiGuard®) did not significantly alter the risk of seroma formation.
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Habal P, Sívková V, Votava P. Comparison of Efficacy and Safety of Non-Regenerated and Regenerated Oxidized Cellulose Based Fibrous Haemostats. ACTA MEDICA (HRADEC KRALOVE, CZECH REPUBLIC) 2022; 65:53-58. [DOI: 10.14712/18059694.2022.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Purpose: Various forms of local haemostats are increasingly used routinely in surgical procedures. Our work is the first comparison of the efficacy and safety of non-regenerated and regenerated oxidized cellulose based fibrous haemostats. Methods: The haemostatic efficacy and safety of fibrous haemostats based on ONRC and ORC were compared in a randomized multicenter study. The primary endpoint was successful haemostasis within 3 minutes of application and no need for surgical revision within 12 hours after the procedure for recurrent bleeding. Results: There was a significant difference in the rate of successful haemostasis in 3 minutes that was achieved in 82% and 55% in the ONRC and ORC groups, respectively (confidence interval 99%; p = 0.009). Mean time to haemostasis was 133.9 ± 53.95 seconds and 178.0 ± 82.33 seconds, in the ONRC, and ORC group, respectively (p = 0.002). Revision surgery for re-bleeding was necessary in 0 (0%), and 1 (2%) of patients in the ONRC, and ORC group, respectively. No adverse events were reported. Conclusion: Fibrous haemostat based on ONRC was non-inferior compared to fibrous haemostat based on ORC when used in accordance with its intended purpose, and was safe and efficient.
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Choi GS, Kim SH, Seo HI, Ryu JH, Yun SP, Koh MY, Lee MS, Lee H, Kim JH. A multicenter, prospective, randomized clinical trial of marine mussel-inspired adhesive hemostatic materials, InnoSEAL Plus. Ann Surg Treat Res 2021; 101:299-305. [PMID: 34796146 PMCID: PMC8564078 DOI: 10.4174/astr.2021.101.5.299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/09/2021] [Accepted: 09/28/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose InnoSEAL Plus is an adhesive, coagulant-free hemostatic material that mimics the adhesion mechanism of marine mussels. This study reports on the safety and efficacy of InnoSEAL Plus for patients with hemorrhage after hepatectomy despite first-line hemostasis treatments. Methods This is a multicenter, prospective, single-blinded, randomized clinical trial involving 96 hepatectomy patients. TachoSil was used as a comparator group. Three-minute and 10-minute hemostatic success rates were monitored. Rebleeding rates were also observed. Safety was assessed by recording all novel undesirable symptoms. Results InnoSEAL Plus showed a 3-minute hemostasis rate of 100%, while TachoSil had a rate of 98.0% (48 of 49 patients), demonstrating that the 2 had similar hemostatic efficacies. The difference in efficacy between the test and comparator group was 2.04%, and the lower limit of the one-sided 97.5% confidence interval was −1.92%; as this is greater than the noninferiority limit of −23.9%, the 2 treatments were equivalent. Meanwhile, the 10-minute hemostatic success rate was the same in both groups (100%). No rebleeding occurred in either group. In the safety evaluation, 89 patients experienced adverse events (45 in the test group and 44 in the comparator group). The difference between the 2 groups was not significant. No death occurred after application of the test or comparator group product. Conclusion Given that InnoSEAL Plus is a coagulation factor-free product, the hemostasis results are encouraging, especially considering that TachoSil contains a coagulation factor. InnoSEAL Plus was found to be a safe and effective hemostatic material for control of bleeding in hepatectomy patients.
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Affiliation(s)
- Gyu-Seong Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seoung Hoon Kim
- Center for Liver Cancer, National Cancer Center, Goyang, Korea
| | - Hyung Il Seo
- Department of Surgery, Pusan National University Hospital, Busan, Korea
| | - Je Ho Ryu
- Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | | | | | | | - Haeshin Lee
- R&D Center, InnoTherapy Inc., Seoul, Korea.,Department of Chemistry, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea
| | - Jae Hun Kim
- Department of Trauma Surgery and Surgical Critical Care, Pusan National University Hospital, Busan, Korea.,Department of Surgery, Pusan National University College of Medicine, Busan, Korea
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