Surgery
haemostats offering advantages against the other, it shows that both gelatin sponge and oxidised cellulose haemostats are still necessary, with each product being better suited to different disciplines, procedures and situations.
The latest advancements in haemostats Although, as stated earlier, very little has changed in gelatin sponge haemostats in the 80 years they have been used, advances are taking place. This can be seen with the recent release of ‘quick’ gelatin sponge products, such as Cutanplast FAST by Mascia Brunelli, where an adaptation to the formulation of the particular structure allows haemostasis to occur in 2-8 minutes and is removed from the body is 2-4 weeks, instead of haemostasis in 5-10 minutes and resorbability in 3-4 weeks from standard gelatin sponge.16 In a study, it was found that FAST gelatin sponge in some instances generated haemostasis quicker than oxidised regenerated cellulose.21
There have also been developments
in oxidised cellulose with advancement on the cotton wool version of the product, with Johnson & Johnson releasing SnoW and Synthesia launching Okcel S, a strengthed cotton wool form, which is suggested to give the product easier handling, improved strength and easier application in laparoscopic surgery.8
Conclusions
Oxidised cellulose and gelatin sponge haemostats have been used by surgeons for 80 years to prevent unwanted bleeding by generating quick and efficient haemostasis. Oxidised cellulose comes in two forms, ORC and ONRC, with multiple studies suggesting ONRC is more absorbent and produces faster haemostasis. Although the standard version of oxidised cellulose is the most commonly used, there may be benefits to considering the heavy- duty and cotton wool forms of the product, due to significantly faster haemostasis. Gelatin sponge haemostats have been
reviewed and the different formats allow a benefit over oxidised cellulose, along with being able to carry antibiotics and it is a lot more economical. Oxidised cellulose does, however, provide faster haemostasis and is removed from the body quicker than standard gelatin sponge. Two advancements in the gelatin sponge and oxidised cellulose market have been found in ‘quick’ gelatin, with the example being Cutanplast FAST from Mascia Brunelli and strengthed cotton wool oxidised cellulose with the example being Okcel S by Synthesia. To conclude, oxidised cellulose and gelatin
sponge haemostats have been in the surgical armoury for 80 years and the two types of haemostats will continue to serve surgeons and doubtless continue to help save many lives. CSJ
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About the Author
Daniel Garrett, Marketing Manager at Uniplex (UK), has been working in the medical device industry since 2017. Over the last 7 years, he has been helping to provide healthcare solutions to the operating room, including haemostats. Daniel has a BA (Hons) in Marketing (Sheffield Hallam University) and is currently studying for an MBA at the University of York.
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