Oxidized regenerated cellulose

Veves A, Sheehan P, Pham HT. A randomized, controlled trial of Promogran (a collagen/oxidized regenerated cellulose dressing) vs standard treatment in the management of diabetic foot ulcers. Arch Surg 2002 137 822-827. 

PoUack, R.P., Bouwsma, O., 1992. Apphcation of oxidized regenerated cellulose in periodontal therapy. Compendium 13, 888—892. 

Rice, V.M., Shanti, A., Moghissi, K.S. and Leach, R.E. (1993) A comparative evaluation of poloxamer 407 and oxidized regenerated cellulose (Interceed [TC7]) to reduce postoperative adhesion formation in the rat uterine horn model. Fertility and Sterility, 59(4), 901-906. 

Regenerated cellulose fibers are uniform in diameter. This permits a tmiform oxidation and imparts uniform chemical and physical characteristics to the pharmaceutical material. In the early 1960 s, Johnson Johnson entered the market with an oxidized knitted rayon fabric, SURGICEL Absorbable Hemostat. Since then, Johnson Johnson has dev eloped a few other oxidized knitted rayon products. A list of currently av ailable bioabsorbable oxidized cellulose and oxidized regenerated cellulose products, and the respecthe manufacturer is contained in TkdUe 1. A list of relevant patents for oxidized cellulose technology is contained in IkUe 2. 

SURGICEL oxidized regenerated cellulose Absorbable Hemostat Ethicon, Inc. ... 

OXYCEL Absorbable oxidized cellulose Hemostat INTERGEED oxidized regenerated cellulose Absorbable Adhesion Barrier Becton-Dickinson. Inc. Ethicon, Inc. ... 

Oxidized regenerated cellulose has been used clinically as an absorbable adhesion barrier since 1989. Available as a knitted fabric (INTERCEED Absorbable Adhesion Barrier), it is the first material in the United States indicated for the prevention of post-operative pelvic adhesions. Since its introduction, additional clinical studies have been completed (Azziz et al, 1993 Sekiba et al, 1992 Franklin et al, 1995 Li Cooke 1994 Nordic Study Group, 1995) that confirm the efficacy of oxidized regenerated cellulose as an adhesion barrier. 

There are two main advantages to using oxidized regenerated cellulose (ORC) for this application. Firsdy, since ORC is biocompatible, peritoneal cells beneath the adhesion barrier can repair damaged membranous surfaces while being separated from apposing tissues. Secondly, since ORC is bioabsorbable, the material serves its function as an adhesion barrier and is removed from the implantation site within 4 weeks so that no further foreign-body reactions can occur. 

Due to the a mlability of many carboxyl groups, oxidized cellulose has a low pH. This accounts for the antibacterial activity produced by oxidized regenerated cellulose... 

Dineen, P. (lOVO) Antibacterial activity of oxidized regenerated cellulose. Surg. Gynecol. Obstei., 142,481-6. Dineen, P. (1977) The effect of oxidized regenerated cellulose on experimental intravascular infection. 

Lebendiger, A., Gitlitz, G.F., Hiiivtitt, E.S., Lord, G.H. and Henderson,/. (1959) Laboratory and clinical eraluation of a new absorbable hemostatic material prepared from oxidized regenerated cellulose. 

Another commonly-used bioabsorbable sheet is Interceed for applications in gynecologic pelvic surgery. It is a knitted fabric of oxidized regenerated cellulose which slowly turns into a gel when placed on tissues. Unlike Seprafilm , Interceed is easy to handle and can be placed via laparoscopy. It has been reported that Interceed prevents tissue adhesion effectively when blood contamination is avoided during application of it [135]. However, as complete blood evacuation is not always possible in chnical situations, surgeons are not keen to use this product. Moreover, increased adhesion formation has been observed when Interceed is applied to areas where blood accumulation cannot be prevented [136]. 

Haney, A.F., Hesla, J., Hurst, B.S., Kettel, L.M., Murphy, A.A., Rock, J.A., Rowe, G., Schlaff, W.D. Expanded polytetrafluoroethylene (Gore-Tex Surgical Membrane) is superior to oxidized regenerated cellulose (Interceed TC7-I-) in preventing adhesions. Fertil. Steril. 63(5), 1021-1026 (1995)... 

Within the range of 16-24% carboxylic acid content, oxidized cellulose has a pH of approximately 3.1. The material is biocompatible, bioabsorbable, and hemostatic. Based on these unique properties, Johnson Johnson pioneered an industrial-scale oxidation process by using nitrogen dioxide to convert regenerated cellulosic fibers into oxidized regenerated cellulose (ORC) fibers. When knitted into a flexible fabric, ORC can be used as an absorbable hemostat in various surgical operations where blood loss should be controlled. 

Akhtar has put forth contradictory studies regarding the toxicity and long-term effects of CA. He cites that Barbalinardo et al. compared relative effectiveness of isobutyl-2-cyanoacrylate, fibrin adhesive, and oxidized regenerated cellulose by the application of these hemostatic agents to sources of point bleeding. They found in the meantime that... 

Barbalinardo RJ, Citrin R Franco CD, Hobson II RW. A comparison of isobutyl 2 ecyanoacrylate glue, fibrin adhesive and oxidized regenerated cellulose for control of needle hole bleeding from polytetrafluoro-ethylene vascular prostheses. J Vase Surg. 1986 4 220-223. 

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