Abstract
Different topical hemostatic materials are used to achieve effective hemostasis. High hemostatic activity, biocompatibility, bioresorbability, and easy manipulation are to be expected in such a developed product. In the surgical world with these specific requirements, finding a proper hemostatic agent is very difficult. The study compared several materials of various construction properties, which were assessed for structural and related properties by morphological analyses and assessed in vivo for their efficiency and behaviour using a model of rat partial nephrectomy. New sodium salt of carboxymethyl cellulose (CMC) sponge with the lowest porosity and free swell absorptive capacity contained the highest amount of hydroxyl and carboxyl groups. Results revealed that this CMC material in the form of a bioresorbable sponge may ensure the necessary hemostatic effects, while also providing a positive influence on the reaction of the local tissue. The CMC material also needed significantly less time to achieve hemostasis (p < 0.001). Moreover, the sponge reached satisfactory results in the histopathological evaluation with the lowest destruction score and favorable healing reaction. This modified product proved itself to be a promising bioresorbable hemostat, which, according to its design, matches with its surgical applications. In general, the obtained data elucidated the dependency of the total effect on its structure and composition.
Graphic abstract
Similar content being viewed by others
Availability of data and materials
Not applicable.
References
Achneck HE, Sileshi B, Jamiolkowski RM, Albala DM, Shapiro ML, Lawson JH (2010) A comprehensive review of topical hemostatic agents: efficacy and recommendations for use. Ann Surg 251:217–228. https://doi.org/10.1097/SLA.0b013e3181c3bcca
Aoshima M, Tanabe K, Kohno I, Jo Y, Takahashi K, Sugo T, Matsuda M (2012) Hemostatic mechanisms of a soluble fraction of plant-derived sodium carboxymethyl cellulose. Jpn J Thromb Hemost 23:387–398. https://doi.org/10.2491/jjsth.23.387
Badenes D, Pijuan L, Curull V, Sanchez-Font A (2017) A foreign body reaction to Surgicel® in a lymph node diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration. Ann Thorac Med 12:55–56. https://doi.org/10.4103/1817-1737.197780
Centeno A, Rojas S, Arias B, Miquel I, Sánchez P, Ureta C, Rincón E, López R, Murat J (2020) Experimental evaluation of a new tissue factor-based topical hemostat (TT-173) for treatment of hepatic bleeding. J Invest Surg 33:339–349. https://doi.org/10.1080/08941939.2018.1517840
Chalupová M, Suchý P, Pražanová G, Bartošová L, Sopuch T, Havelka P (2012) Local tissue reaction after the application of topical hemostatic agents in a rat partial nephrectomy model. J Biomed Mater Res A 100:1582–1590. https://doi.org/10.1002/jbm.a.34098
El-Sakhawy M, Milichovsky M (2000) Oxycellulose modification. Polym Int 49:839–844. https://doi.org/10.1002/1097-0126(200008)49:8%3c839::AID-PI463%3e3.0.CO;2-T
Fontes CER, Mardegam MJ, Prado-Filho OR, Ferreira MV (2018) Comparative analysis of surgical hemostatic sponges in liver injury: study in rats. ABCD Arq Bras Cir Dig 31:e1342. https://doi.org/10.1590/0102-672020180001e1342
Fukuzumi H, Saito T, Okita Y, Isogai A (2010) Thermal stabilization of TEMPO-oxidized cellulose. Polym Degrad Stab 95:1502–1508. https://doi.org/10.1016/j.polymdegradstab.2010.06.015
Hassouna HA, Manikandan R (2012) Hemostasis in laparoscopic renal surgery. Indian J Urol 28:3–8. https://doi.org/10.4103/0970-1591.94939
Huri E, Akgul T, Ayyildiz A, Ustun H, Germiyanoglu C (2009) Hemostatic role of a folkloric medicinal plant extract in a rat partial nephrectomy model: controlled experimental trial. J Urol 181:2349–2354. https://doi.org/10.1016/j.juro.2009.01.016
Ikehara S, Sakakita H, Ishikawa K, Akimoto Y, Yamaguchi T, Yamagishi M, Kim J, Ueda M, Ikeda JI, Nakanishi H, Shimizu N, Hori M, Ikehara Y (2015) Plasma blood coagulation without involving the activation of platelets and coagulation factors. Plasma Process Polym 12:1348–1353. https://doi.org/10.1002/ppap.201500132
Lemoy MMF, Schouten AC, Canfield DR (2016) Granuloma due to oxidized regenerated cellulose in an aged rhesus macaque (Macaca mulatta). Comp Med 66:59–62
MacDonald MH, Wang AY, Clymer JW, Hutchinson RW, Kocharian R (2017) An in vivo comparison of the efficacy of hemostatic powders, using two porcine bleeding models. Med Devices 10:273–279. https://doi.org/10.2147/MDER.S140663
Ohta S, Nishiyama T, Sakoda M, Machioka K, Fuke M, Ichimura S, Inagaki F, Shimizu A, Hasegawa K, Kokudo N, Kaneko M, Yatomi Y, Ito T (2015) Development of carboxymethyl cellulose nonwoven sheet as a novel hemostatic agent. J Biosci Bioeng 119:718–723. https://doi.org/10.1016/j.jbiosc.2014.10.026
Ozgor F, Simsek A, Aydogdu O, Kucuktopcu O, Sarilar O, Berberoglu AY, Akbulut MF, Binbay M (2016) Bleeding during laparoscopic partial nephrectomy: can a hemostatic matrix help to improve hemostasis? Arch Ital Urol Androl 88:228–232. https://doi.org/10.4081/aiua.2016.3.228
Panwar V, Thomas J, Sharma A, Chopra V, Kaushik S, Kumar A, Ghosh D (2020) In-vitro and in-vivo evaluation of modified sodium starch glycolate for exploring its haemostatic potential. Carbohydr Polym 235:115975. https://doi.org/10.1016/j.carbpol.2020.115975
Samudrala S (2008) Topical hemostatic agents in surgery: a surgeon’s perspective. AORN J 88:s2-11. https://doi.org/10.1016/S0001-2092(08)00586-3
Schonauer C, Tessitore E, Barbagallo G, Albanese V, Moraci A (2004) The use of local agents: bone wax, gelatin, collagen, oxidized cellulose. Eur Spine J 13:89–96. https://doi.org/10.1007/s00586-004-0727-z
Slezak P, Keibl C, Labahn D, Schmidbauer A, Genyk Y, Gulle H (2020) A comparative efficacy of recombinant topical thrombin (RECOTHROM®) with a gelatin sponge carrier versus topical oxidized regenerated cellulose (TABOTAMP®/SURGICEL®) in a porcine liver bleeding model. J Invest Surg. https://doi.org/10.1080/08941939.2019.1705444
Song H, Zhang L, Zhao X (2010) Hemostatic efficacy of biological self-assembling peptide nanofibers in a rat kidney model. Macromol Biosci 10:33–39. https://doi.org/10.1002/mabi.200900129
Spangler D, Rothenburger S, Nguyen K, Jampani H, Weiss S, Bhende S (2003) In vitro antimicrobial activity of oxidized regenerated cellulose against antibiotic-resistant microorganisms. Surg Infect (larchmt) 4:255–262. https://doi.org/10.1089/109629603322419599
Suchý P, Paprskářová A, Chalupová M, Marholdová L, Nešporová K, Klusáková J, Kuzmínová G, Hendrych M, Velebný V (2020) Composite hemostatic nonwoven textiles based on hyaluronic acid, cellulose, and etamsylate. Materials (basel) 13:1627. https://doi.org/10.3390/ma13071627
Wang J, Somasundaran P (2005) Adsorption and conformation of carboxymethyl cellulose at solid-liquid interfaces using spectroscopic, AFM and allied techniques. J Colloid Interf Sci 291:75–83. https://doi.org/10.1016/j.jcis.2005.04.095
Wu Y, Wang F, Huang Y (2018) Comparative evaluation of biological performance, biosecurity, and availability of cellulose-based absorbable hemostats. Clin Appl Thromb Hemost 24:566–574. https://doi.org/10.1177/1076029617751177
Yan T, Cheng F, Wei X, Huang Y, He J (2017) Biodegradable collagen sponge reinforced with chitosan/calcium pyrophosphate nanoflowers for rapid hemostasis. Carbohydr Polym 170:271–280. https://doi.org/10.1016/j.carbpol.2017.04.080
Yucel MO, Polat H, Bagcioglu M, Karakan T, Benlioglu C, Cift A, Gok A, Astarci HM, Akgul T, Germiyanoglu C (2016) Comparison of the efficacy and histopathological effects of three hemostatic agents in a partial nephrectomy rat model. Int Urol Nephrol 48:65–71. https://doi.org/10.1007/s11255-015-1129-3
Zhang S, Li J, Chen S, Zhang X, Ma J, He J (2020) Oxidized cellulose-based hemostatic materials. Carbohydr Polym 230:115585. https://doi.org/10.1016/j.carbpol.2019.115585
Acknowledgments
This study was funded by the Grant IGA VFU BRNO (322/2016/FaF) and solved with the financial support of TA ČR (TH04020540).
Author information
Authors and Affiliations
Contributions
Conceptualization: [Pavel Suchý, Tomáš Sopuch, Lucy Vojtová]; Methodology: [Pavel Suchý, Lucy Vojtová]; Formal analysis and investigation: [Alice Paprskářová, Pavel Suchý, Marta Chalupová, Lenka Michlovská, Jarmila Klusaková, Lucy Vojtová]; Writing—original draft preparation: [Alice Paprskářová, Lenka Michlovská, Tomáš Sopuch, Lucy Vojtová]; Writing—review and editing: [Alice Paprskářová, Pavel Suchý, Marta Chalupová, Lenka Michlovská, Tomáš Sopuch, Lucy Vojtová]; Funding acquisition: [Alice Paprskářová, Pavel Suchý, Tomáš Sopuch, Lucy Vojtová]; Resources: [Pavel Suchý, Jarmila Klusáková, Tomáš Sopuch, Lucy Vojtová]; Supervision: [Pavel Suchý, Tomáš Sopuch, Lucy Vojtová].
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Paprskářová, A., Suchý, P., Chalupová, M. et al. Evaluation and comparison of structurally different cellulose-based hemostatic agents in a rat kidney model. Cellulose 28, 9369–9382 (2021). https://doi.org/10.1007/s10570-021-04104-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10570-021-04104-1