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Diagnosis
Published in Marc A. Levitt, Pediatric Colorectal Surgery, 2023
The device is placed inside the anal verge, and two to three specimens are obtained posteriorly and laterally (Figure 10.2). It is vital to not take the biopsy too high (greater than 3 cm), as you could miss the aganglionosis, or too low, because the anal canal is aganglionic in all patients. Bleeding after the procedure is rare, but if it happens, a digital exam with the fifth digit pressing down on the sacrum stops the bleeding. Additionally, insertion of a tampon/plug created with Surgicel™ (oxidized regenerated cellulose) may be used to control capillary, venous, and small arterial bleeding.
Instruments and Machines
Published in Qais Hooti, Sung-Hoo Hong, Minimally Invasive Urologic Surgery, 2023
Surgicel is made of oxidized cellulose polymer and manufactured by Ethicon. It is absorbable and can be cut to small sizes appropriate to cover the bleeding area.
Dorsum Surgery
Published in Suleyman Tas, Rhinoplasty in Practice, 2022
The diced cartilage method can be used in three different ways: FreeIn SurgicelIn fascia Here, Surgicel and fascia are used to mold chopped cartilage as a scaffold, although the use of the mold will also logically increase the risk of absorption as it will prevent contact of the cartilage grafts with viable surfaces [56].
A Prospective, Single-Blind, Randomized, Phase III Study to Evaluate the Safety and Efficacy of Fibrin Sealant Grifols as an Adjunct to Hemostasis During Soft Tissue Open Surgery
Published in Journal of Investigative Surgery, 2020
Shankar Lakshman, Keith Aqua, Aleksandar Stefanovic, Srdjan Djurdjevic, Péter Nyirády, Péter Osváth, Ronald Davis, Arnold Bullock, Junliang Chen, Julia Ibañez, Gladis Barrera, Jordi Navarro-Puerto
It is important to note that Surgicel® is a non-active hemostat whereas FS Grifols is an active FS product. Surgicel® combines the hemostatic properties of the product, such as its nature and composition (oxidized regenerated cellulose) and its physical properties (barrier effect), with active manual compression required by the user which needs to be applied for the entire duration of the hemorrhage until bleeding stops. On the other hand, FS Grifols is applied to the TBS and the operator does not need to take any other action (e.g. manual compression) for the product to work, only needing to observe the TBS and be ready to apply additional amounts of product in case initial application is not sufficient to arrest bleeding or does not sufficiently cover the intended target area. Thus, while economic considerations are beyond the scope of this study, one could speculate that application of active FS products, which do not require manual compression, would allow the surgical team to avoid spending operative time conducting a physical activity such as applying manual compression until hemostasis is achieved, therefore releasing valuable resources in the operating room.
Clinical effectiveness and versatility of a sealing hemostatic patch (HEMOPATCH) in multiple surgical specialties
Published in Expert Review of Medical Devices, 2018
Kevin M. Lewis, Shelly Ikeme, Tolu Olubunmi, Carl Erik Kuntze
Cost studies of a novel fibrin sealant matrix, EVARREST, compared to standard of care have shown cost savings for hepatic surgery in a US hospital setting [8] and for soft tissue surgery in Italian, German, and UK hospital settings [69–71]. Similarly, a retrospective cost analysis of brain/cerebral surgery, cardiovascular surgery, and carotid endarterectomy using a US hospital database found lower resource utilization and costs associated with the use of SURGICEL advanced products [72]. While many of these agents provide benefit over standard of care, future research should focus on comparing the advanced topical hemostats. This type of research can help guide clinical use as it did for flowable hemostatic matrices [73–75].
Intraoperative hemostatic agents in orbital surgery
Published in Orbit, 2022
Edward J. Wladis, George Stavropoulos, Charlotte L. Marous
Surgicel (Ethicon, Somerville, NJ) is an oxidized variant of cellulose that promotes an acidic microenvironment. Consequently, application of this modality results in a coagulum, and enhances clot formation.8,9 Additionally, Surgicel is bacteriostatic and is gradually resorbed after application. Despite these advantages, this device may expand and act as a space-occupying mass, and Arat et al reported cases of compressive optic neuropathy after its use.13