Surgicel SNoW (Oxidized Regenerated Cellulose) - Uses, How to Use?

Oxidized Regenerated Cellulose (Surgicel SNoW) is a modified form of cellulose that swells and forms a meshwork when comes in contact with blood. It is used in hemostasis to control bleeding when other measures are not practical.

Oxidized regenerated cellulose Uses:

Hemostasis:
- It is used in conjunction with other surgical procedures to control bleeding (from capillaries, veins, or small arteries) when other measures to control bleeding may not be effective or are impractical.

Oxidized Regenerated Cellulose (Surgicel SNoW) Dose in Adults

Oxidized Regenerated Cellulose (Surgicel SNoW) Dose in the Hemostasis:

Topical: A minimum amount of the oxidized regenerated cellulose is laid or applied to the site of bleeding or held firmly against the tissues until the bleeding stops. The excess material is then removed.

Use in Children:

It can be used in children to stop bleeding during surgeries. It has been used in children with epistaxis and following adenoid surgery to control bleeding.

Pregnancy Risk Category: C

It has been tested for use in gynecologic surgery, such as myomectomy or other local procedures.
It can also be used by breastfeeding mothers to control their bleeding.

Dose in Renal disease:

No dosage adjustment has been provided in patients with renal disease.

Dose in Liver disease:

No dosage adjustment has been provided in patients with liver disease.

Side effects of Oxidized Regenerated Cellulose (Surgicel SNoW):

It may have local side effects such as erythema, redness, and pruritis.

Neurotoxic side effects have been mentioned when it is placed near nerves for the control of dental procedures-related bleeding.

Contraindications to Oxidized Regenerated Cellulose (Surgicel SNoW):

Allergies to any component of this formulation
Use to stop bleeding from open blood vessels
Use in fractures (Implantation of bone defects);
Large artery bleeding;
Oozing that is not hemorhagic
Use as an adhesive product

Warnings and precautions

Reactions of foreign bodies:
- It could cause a foreign body reaction. To reduce risk and facilitate absorption, the excess product must be removed prior to surgical closure.
Pain/ numbness/ nerve damage/ paralysis:
- If the product is near nerves, bony surfaces, optic nerves/ chiasms, neurotoxic effects can occur.
- Patients might experience pain, numbness or nerve damage.
- To achieve hemostasis, you should only use a small amount of the product.

Monitoring parameters:

Monitor the site for hemostasis/ bleeding.
Monitor CBC, coagulation profile, and the site for infection.
Monitor for neurotoxicity if the product is placed near a nerve.

How to administer Oxidized Regnerated Cellulose (Surgicel SNoW)?

Surgicel Pad:

It may be sutured or cut without fraying.

Powder:

The precise amount of the powder is difficult to deliver since it is available in a dry powdered form.
The applicator tip should not be trimmed (applicator tip not intended for laparoscopic or other endoscopic use).

Mechanism of action of Oxidized Regenerated Cellulose (Surgicel SNoW):

The site of bleeding is oxidized regeneratedcellulose.
It becomes a gelatinous, brownish-black mass at the site where there is bleeding.
This helps to form a blood clot. It is easily absorbed by the sites of implantation in very small quantities.
It has also been shown in vitro to have bactericidal properties.
Its hemostatic effect has not been shown to increase when thrombin was added.

Absorption: