The formation of adhesion following strabismus surgery may result in restrictive ocular motility dysfunction. We performed conventional recessions of both inferior and superior rectus muscle in right eyes of 11 white rabbits as control group and a sheet of 2 x 2 mm absorbable cellulose(Interceed, TC7) was inserted between rectus muscle and conjunctiva in left eyes of 11 rabbits as interceed group in the hope of preventing postoperative adhesion. We examined conjunctival injection, corneal abrasion, scleral necrosis and discharge at 1st, 2nd day, 1st, 2nd, 4th, 6th week following surgery and examined muscle adhesion powers by spring gauge and degrees of adhesion by blunt disection and histopathologic examination with light microscope at 6th week. The postoperative corneal and conjunctival findings and muscle adhesion powers were similar but degrees of adhesion at both blunt dissection and histopathologic examination revealed statistically significant reduction of adhesion in absorbable cellulose group than control group. From these findings, it would appear that the use of absorbable cellulose is effective in preventing postoperative adhesion following strabismus surgery .
Cellulose, Oxidized ; Conjunctiva ; Hope ; Necrosis ; Rabbits* ; Strabismus*

BACKGROUND: Many topical hemostatics are widely applied for bleeding control. They can be classified into two categories according to their mechanism of action on the clotting cascade in a biologically active or passive manner. Passive hemostatics include cellulose and gelatin. We performed an experimental study to compare the effect of passive hemostatics in wound healing by applying them to a rectus abdominis muscle defect of white mice. METHODS: Surgicel is a sterile absorbable knitted fabric prepared by the controlled oxidation of regenerated cellulose. Spongostan is an absorbable hemostatic gelatin sponge. In 30 mice, a 1x1 cm defect was created on the rectus abdominis muscle and the materials were applied in three ways: control group, cellulose (Surgicel) group, gelatin (Spongostan) group. For the histologic analysis, biopsies were performed at 3 and 28 days. RESULTS: After 3 days, the cellulose group showed limited granulation formation with acute inflammatory reactions similar to the control group. At the 28th day, moderate amounts of granulation tissue formation was observed with milder inflammatory reactions than the control group. In the gelatin group, after 3 days, gelatin remnants were observed surrounded by severe inflammatory changes. After 28 days, the same quantity of gelatin remnants could be still observed. CONCLUSIONS: This study suggests that cellulose is associated with minimal morbidity in wound healing, while the use of gelatin shows severe adverse tissue reactions with delayed wound healing. Consequently, cellulose is better than gelatin when considering wound healing.
Animals ; Biopsy ; Cellulose ; Cellulose, Oxidized ; Fibrin Foam ; Gelatin ; Granulation Tissue ; Hemorrhage ; Hemostatics ; Humans ; Mice ; Muscles ; Porifera ; Rectus Abdominis ; Wound Healing

oxidized cellulose(Surgicel ) membrane was shown to have potential for use as an absorbable barrier membrane for regenerative procedure and it would not require surgical removal. The purpose of this study is to investigate the absorption periods of oxidized cellulose at the implant site and usefulness as a mechanical barrier, preventing the ingrowth of the overlying soft tissue into the bony defects. Two bony defects were made in each tibia of a dog using drill and one defect covered with oxidized cellulose and the other covered with oxidised cellulose and the other covered with periosteum directly as control. The experimental animals were sacrificed at lst-7th, 10th, 14th, 21th, 28th, day postoperatively. Inspection of the specimens was done to evaluate gross changes. Specimens were examined histopathologically by hematoxylin-eosin and Masson's trichrome staining under light microscope. The results were as follows: 1. There was no significant differences of inflammatory reaction between the experimental and the control group. 2. The resorption of oxidized cellulose was almost completed within 14th day. 3. Histologically, bone formation in the experimental group was somewhat more than that fo the control group at 10th, 14th, 2th and 28th day postoperatively. The bone forming pattern of the experimental group was more regular than that of the control group. 4. There was no evidence of soft tissue invasion into the bony defect in the experimental group. In conclusion, oxidized cellulose membrane night be used as an alternative absorbable barrier membrane to prevent overlying soft tissue invasion into the bony defects.]]>
Absorption ; Animals ; Cellulose ; Cellulose, Oxidized ; Dentistry ; Dogs ; Humans ; Inflammation ; Jaw ; Mandible ; Maxilla ; Membranes ; Osteogenesis ; Periosteum ; Research Personnel ; Tibia

PURPOSE: The aim of this study was to investigate the current status of the use of antiadhesive agents (AAdAs) via a questionnaire and to discuss the availability of AAdAs. METHODS: The survey was sent to a list of members that was approved by the Korean Gastric Association. The survey included questions on AAdA use by surgeons, the type of AAdAs used, and the reasons for not using AAdAs. Surgeons were also asked to describe complications related to AAdAs, and the reliability of its use. RESULTS: The response rate was 21%. The rates of frequent use stratified by procedure were 26.9% (14/52) for open gastrectomy, 5.9% (3/51) for laparoscopic gastrectomy, and 31.5% (17/54) for surgery for postoperative bowel obstruction (P < 0.01). After including data from the occasional use group, the corresponding values were 51.9% (27/52), 19.6% (10/51), and 70.4% (38/54), respectively (P < 0.01). Sefrafilm and Guardix were most commonly used for open procedures. Guardix and Interceed were most commonly used for laparoscopic surgery. The primary reasons for nonuse of AAdAs were ineffectiveness and high cost. Ten percent (4/40) of surgeons observed complications associated with AAdAs. A minority (17.3%, 9/52) had positive attitudes toward AAdAs. The majority of respondents expressed neutral (73.1%, 38/52) or negative (9.6%, 5/52) attitudes toward AAdAs. CONCLUSION: The low use rates of AAdAs in gastric cancer surgery may be attributable to perceptions that AAdAs are ineffective, unreliable, and costly. We anticipate the emergence of promising antiadhesive strategies that reach far beyond the limitations of current products.
Cellulose, Oxidized ; Gastrectomy ; Laparoscopy ; Morinda ; Postoperative Complications ; Surveys and Questionnaires ; Republic of Korea ; Stomach Neoplasms ; Surveys and Questionnaires

PURPOSE: Tissue adhesion is a well-known postsurgical phenomenon, causing pain, functional obstruction, and difficult reoperative surgery. To overcome these problems, various synthetic and natural polymer membranes have been developed as postoperative tissue adhesion barriers. However, limitation in their use has hindered its actual application. We prepared a hyaluronate membrane (HM) to evaluate its efficacy and safety as an adhesion barrier compared to a commercialized product (Interceed, Ethicon). METHODS: To evaluate the antiadhesion effect, a cecum-abdominal wall abrasion model was adopted in a rabbit. The denuded cecum was covered by Interceed or HM or neither and apposed to the abdominal wall (each, n = 10). Four weeks after surgery, the level of adhesion was graded. Acute and chronic toxicity of the three groups were also evaluated. RESULTS: Blood samples drawn to evaluate acute toxicity at postoperative day 3 and 7 showed no significant difference among the three groups. The grade and area of adhesion were significantly lower in the HM compared to those of the control and Interceed at four weeks after surgery. Histologic evaluations, which was carried out to estimate tissue reactions at the site of application, as well as to assess chronic toxicity for the major organs, were not significantly different in the three groups. CONCLUSION: This study showed that the antiadhesion efficacy of HM was superior to commercialized antiadhesion membrane, Interceed. Low inflammatory response and nontoxicity were also demonstrated. From these results, we suggest that the HM is a good candidate as a tissue adhesion barrier.
Abdominal Wall ; Cecum ; Cellulose, Oxidized ; Hyaluronic Acid ; Membranes ; Polymers ; Tissue Adhesions

Airway Obstruction ; Arteries ; Cellulose, Oxidized ; Hemorrhage ; Hemostasis ; Humans ; Male ; Mandible ; Postoperative Hemorrhage

21-year-old male was admitted for evaluation of a mass shadow on chest film. On chest computed tomography showed 5 cm sized homogeneous low density based on the second thoracic vertebral body in the posterior mediastinum. The patient had been performed thoracic sympathectomy 6 months before admission and oxidized cellulose was used for hemostasis at that operation Surgical resection was performed and microscopic result was foreign body granuloma caused by oxidized cellulose. Oxidized cellulose is an absorbable sterile mesh and used to control capillary or venous bleeding. Although the manufacturer recommends its removal after hemostasis is achieved, in clinical practice it is usually left in situ to reabsorb spontaneously, usually with no untoward effect.
Capillaries ; Cellulose, Oxidized ; Foreign Bodies* ; Granuloma, Foreign-Body* ; Hemorrhage ; Hemostasis ; Humans ; Male ; Mediastinum* ; Sympathectomy ; Thorax ; Young Adult

BACKGROUND: To evaluate the efficacy of cellulose mesh with fibrin glue to decrease recurrence rate after bullectomy for a treatment of primary spontaneous pneumothorax. MATERIAL AND METHOD: 222 patients underwent a bullectomy for primary spontaneous pneumothorax in our institute between April. 1996, and June, 2000. Patients were divided into four groups by period and operation method. Group 1(n=25) underwent video-assited thorasic surgery(VATS) and mechanical pleurodesis between 1996 and 1997. Group 2(n=53) underwent axillary thoracotomy and mechanical pleurodesis between the same period. Group 3(n=110) undewent VATS and mechanical pleurodesis between 1998 and April, 2000. Group 4(n=34) underwent VATS and reinforcement with absorbable cellulose mesh and fibrin glue between 1998 and June, 2000. The data of recurrence rate, duration of air leakage, and duration of chest tube drainage evaluated by each group were compared and analysed using general linear model procedure. RESULT: There were 203 men and 19 women. Mean age was 23.2+9.6 years. Recurrent rate in group 1 was 25%, 3.8% in group 2 and 4.5% in group 3. Threre was no recurrence of pneumothorax in group 4. All recurrent cases after bullectomy were developed at the period of surgeon' s experience of bullectomy if it was less than 2 years. Chest tube indwelling period in group 4 was shorter compared to that of group 1,group 2(p<0.0006) and group 3(p<0.0001). There was no postoperative air- leakage in group 4. Recurrence rate was higher in minimal and moderate size pneumothorax than that in massive pneumothorax. In the 12 recurred cases, nine cases had blebs near the suture line. CONCLUSION: The covering of the suture area with an bsorbable cellulose mesh and the application of the fibrin glue on the mesh in wedge resection of blebs are effective and shorter tube indwelling period was resulted. There were no postoperative air leakage through chest tube after this additional procedure and no recurrence in short term follow-up period. Recurrence rate was higher in small size pneumothorax than that in large sizepneumothorax. Recurrence rate was also influenced by the experience of surgeon.
Blister ; Cellulose ; Cellulose, Oxidized* ; Chest Tubes ; Drainage ; Female ; Fibrin Tissue Adhesive* ; Fibrin* ; Follow-Up Studies ; Humans ; Linear Models ; Male ; Pleurodesis ; Pneumothorax* ; Recurrence ; Sutures* ; Thoracic Surgery, Video-Assisted ; Thoracotomy

PURPOSE: To evaluate the antiadhesive effects and safety of an oxidized regenerated cellulose (Interceed) after thyroidectomy. METHODS: Seventy-six thyroidectomized patients were prospectively randomized into two groups with regard to the use of Interceed. We evaluated each group for their adhesive symptoms using four subjective and four objective items at the 2nd week, 3rd and 6th month after thyroidectomy. All patients were examined for vocal cord motility by indirect laryngoscope at each period. RESULTS: Total adhesion scores at each postoperative follow-up period decreased with time, but were not significantly different in each group. The median score for swallowing discomfort for liquid was significantly lower in the Interceed group than in the control group 2 weeks after surgery. In addition, the severity of skin adhesion to the trachea was reduced in the Interceed group compared with the control group 6 months after surgery. During the study, there were no adverse effects or significant differences in postoperative complications between the groups. CONCLUSION: Interceed appeared to be safe and effective in improving neck discomfort at early postoperative periods and preventing skin adhesion to the trachea 6 months after thyroidectomy.
Adhesives ; Cellulose ; Cellulose, Oxidized ; Deglutition ; Follow-Up Studies ; Humans ; Laryngoscopes ; Neck ; Postoperative Complications ; Postoperative Period ; Prospective Studies ; Skin ; Thyroidectomy ; Trachea ; Vocal Cords

PURPOSE: Adequate hemostasis is important for postoperative outcomes of abdominal surgery. This study evaluated the hemostatic effects and accompanying histopathological changes of a novel oxidized regenerated cellulose, SurgiGuard®, during abdominal surgery. MATERIALS AND METHODS: Ten pigs underwent wedge resection of the spleen (1×1 cm) and liver (1.5×1.5 cm). The resected surface was covered with Surgicel® fabric or fibril type (Group A) or SurgiGuard® fabric or fibril type (Group B). Surgicel® and SurgiGuard® were randomized for attachment to the resected surface by fabric type (n=5) or fibril type (n=5). Blood loss was measured 5, 7, and 9 min after resection. Pigs were necropsied 6 weeks postoperatively to evaluate gross and histopathological changes. RESULTS: There was no significant difference in total blood loss between groups [spleen fabric: Group A vs. Group B, 4.38 g (2.74–6.43) vs. 3.41 g (2.46–4.65), p=0.436; spleen fibril: Group A vs. Group B, 3.44 g (2.82–6.07) vs. 3.60 g (2.03–6.09), p=0.971; liver fabric: Group A vs. Group B, 4.51 g (2.67–10.61) vs. 6.93 g (3.09–9.95), p=0.796; liver fibril: Group A vs. Group B, 3.32 g (2.50–8.78) vs. 3.70 g (2.32–5.84), p=0.971]. Histopathological analysis revealed no significant difference in toxicities related to Surgicel® or SurgiGuard® [inflammation, fibrosis, foreign bodies, and hemorrhage (spleen: p=0.333, 0.127, 0.751, and 1.000; liver: p=0.155, 0.751, 1.000, and 1.000, respectively)]. CONCLUSION: SurgiGuard® is as effective and non-toxic as Surgicel® in achieving hemostasis after porcine abdominal surgery.
Animals ; *Blood Loss, Surgical/statistics & numerical data ; Cellulose, Oxidized/*therapeutic use ; Hemostasis, Surgical/*methods ; Hemostatics/*therapeutic use ; Liver/*surgery ; Random Allocation ; Spleen/*surgery ; Swine