Regenerated oxidised cellulose versus calcium alginate in controlling bleeding from malignant breast cancer wounds: randomised control trial study protocol.

OBJECTIVE: Malignant wounds due to breast cancer can present with recurrent episodes of bleeding in the tumour tissue. This study will compare the efficacy of a calcium alginate dressing (Biatain, Coloplast A/S, Denmark) and a regenerated oxidised cellulose dressing (Surgicel, Ethicon, LLC, Puerto Rico). PROTOCOL: A total of 24 patients with breast cancer and bleeding, malignant wounds will be enrolled in the randomised, controlled, open study, conducted at a hospital specialising in breast cancer treatment and at another hospital specialising in palliative care. Patients over 18 years old, with bleeding and willing to undergo venipuncture for blood collection will be included. All enrolled patients will be randomised for allocation to an experimental group (regenerated oxidised cellulose dressing) or a control group (calcium alginate dressing). The main intervention will consist of the application of the haemostatic product, assessment of digital pressure and estimation of the time required for haemostasis. OUTCOMES: Key outcome measures will be the percentage of patients with haemostasis within 20 minutes, observation of haemostasis after three, five and 10 minutes, in addition to recurrence of bleeding and the quantity of product used. DISCUSSION: To our knowledge, this is the first study to evaluate the effectiveness of haemostatic products in malignant wounds. This type of wound is poorly explored in the literature and, among its signs and symptoms, bleeding is poorly studied. The completion of this study will provide a more robust rationale for clinical decision-making related to the control of bleeding in malignant breast cancer wounds in the context of evidence-based nursing practices.

Effects of laser therapy on experimental wound healing using oxidized regenerated cellulose hemostat.

OBJECTIVE: The aim of this paper was to evaluate if the healing of wound sites containing oxidized regenerated cellulose hemostat can be optimized by laser therapy. BACKGROUND DATA: Topical hemostatic agents may be used to control bleeding in a variety of surgical sites. Hemostatic oxidized regenerated cellulose can cause strange body reactions and formation of granulomas. MATERIALS AND METHODS: Thirty-six male Wistar rats averaging 6 wk of age, weighing 250 g each, were anesthetized had a standard 0.5-cm(2) block of oxidized regenerated cellulose (Surgicel) inserted into an incision on the back of the tongue. Postoperatively the animals were randomly divided into two groups of 18 animals each: one was irradiated and one was not irradiated (control). In the treatment group, transmucosal laser therapy was applied in one area (Ga-Al-As laser, 4 J/cm(2), lambda = 685 nm, 35 mW, varphi = 0.06 mm) and consisted of four sessions, with one session carried out every 48 h. The animals were killed at three different times: G1 (1 d), G2 (3 d), and G3 (7 d). Tissues were stained with hematoxylin and eosin and then analyzed. RESULTS: It was observed that the treated group exhibited a greater reduction in edema and inflammatory infiltrate. CONCLUSIONS: These results suggest that laser therapy at 685 nm could improve the healing process, even when the inflammatory process has been stimulated by oxidized regenerated cellulose hemostat.

The use of oxidized regenerated cellulose (surgicel) in closing Schneiderian membrane tears during the sinus lift procedure / El uso de celulosa oxidada regenerada (Surgicel®) para cerrar las roturas de la membrana de Schneider durante el procedimiento quirúrgico del levantamiento del seno

During the sinus lift procedure, undesirable perforations of the Schneiderian membrane can occur in up to 58of cases. Several methods for their closing exist. This article presents a method of covering the perforation with a strip of oxidized regenerated cellulose (Surgicel). One or two layers of material swell after being saturated with blood, turning into a gelatinous mass and forming a tight and mechanically resistant seal. This simple method has been successfully tested on 223 perforations of the Schneiderian membrane that occurred over a period of 58 months.

Durante el procedimiento quirúrgico del levantamiento del seno, pueden producirse perforaciones indeseables de la membrana sinusal, hasta en el 58% de los casos. Existen varios métodos de cierre. Este artículo presenta un método para cubrir la perforación con una lámina de celulosa oxidada regenerada (Surgicel®). Una o dos capas del material se hinchan luego de ser saturadas con sangre, transformándose en una masa gelatinosa, y formando así un sello consistente y mecánicamente resistente. Este método simple ha sido probado con éxito en 223 perforaciones de la membrana de Schneider ocurridas en un período de 58 meses.

The use of oxidized regenerated cellulose (surgicel) in closing Schneiderian membrane tears during the sinus lift procedure.

During the sinus lift procedure, undesirable perforations of the Schneiderian membrane can occur in up to 58% of cases. Several methods for their closing exist. This article presents a method of covering the perforation with a strip of oxidized regenerated cellulose (Surgicel). One or two layers of material swell after being saturated with blood, turning into a gelatinous mass and forming a tight and mechanically resistant seal. This simple method has been successfully tested on 223 perforations of the Schneiderian membrane that occurred over a period of 58 months.

[Modification of the Abbe-Wharton-McIndoe technique using regenerated oxidized cellulose instead of a skin graft]. / Modificación a la técnica de Abbe-Wharton-McIndoe, utilizando celulosa oxidada regenerada en vez de injerto de piel.

Many conditions have an abnormal development of the vagina, which impair satisfactory sexual activity. Non-surgical and surgical procedures have been developed to correct this situation, the Abbe-Wharton-McIndoe operation is one with the best results, but it has the disadvantage that the scar produced in the place where the skin graft is taken has an awful appearance. Although the oxidized regenerated cellulose (ORC) has been extensively used in pelvic surgery to avoid or diminish the adhesion formation, no other uses have been described for this material; we decided to use ORC instead of skin graft at the moment of the Abbe-Wharton-McIndoe procedure, in order to achieve rapid epithelization of the recently created cavity and avoiding skin graft taken. This is the report of four cases with Rokitansky syndrome in which a vagina was created using the McIndoe procedure and ORC was used instead of skin graft. At 12 weeks after surgery a complete epithelization of the new open cavity was achieved with the presence of mature vaginal epithelium. The conclusion is that ORC is an alternative instead of skin graft, with the advantage of avoiding the skin graft taken as well as the scar obligatorily produced with that procedure, and also achieving a complete and quick epithelization of the new cavity.