Surgi-Cell is a sterile, absorbable material employed by surgeons to control bleeding during various operative procedures. This specialized product functions as a local hemostatic agent, applied directly to a wound site to achieve cessation of blood flow. It is a trade name for Oxidized Regenerated Cellulose (ORC). The material’s unique chemical and physical structure allows it to interact rapidly with blood components, initiating a localized process that supports the body’s natural clotting cascade.
What is Oxidized Regenerated Cellulose
Oxidized Regenerated Cellulose, the base material for products like Surgi-Cell, is created through a chemical modification process applied to purified cellulose. This process involves the controlled oxidation of the cellulose polymer, which introduces carboxylic acid groups into the molecular structure. The resulting material is a pale-yellow, fabric-like sheet or mesh that is pliable and can be easily trimmed or packed into irregular wound spaces. A defining characteristic of ORC is its inherently acidic nature, resulting in a low pH environment when the material becomes saturated with blood. The regeneration step in its production ensures a uniform fiber structure, which enhances its ability to absorb fluid and maintain its form during placement.
The Hemostatic Mechanism
The action of Oxidized Regenerated Cellulose in stopping blood flow is primarily a mechanical and chemical process distinct from the body’s intrinsic coagulation cascade. When the ORC material encounters blood, the low pH created by the acidic environment acts immediately on the blood components. This acidic condition causes the rapid denaturation of proteins, leading to the immediate agglutination, or clumping, of red blood cells and platelets at the material’s surface.
These aggregated blood components become trapped within the fine fibrous mesh of the ORC structure, quickly forming a dark, sticky, gelatinous mass that physically adheres to the tissue. The material is thought to concentrate plasma proteins and clotting factors in the local area due to its absorbent and ionic properties. This localized concentration helps accelerate the formation of a robust, mechanical plug that physically seals the bleeding vessel.
Common Surgical Applications
Surgi-Cell is frequently utilized in surgical settings where conventional methods of controlling hemorrhage are either ineffective, impractical, or carry too high a risk of tissue damage. It is a favored tool in general surgery for managing diffuse bleeding from large surface areas, such as the liver or spleen, where sutures may tear fragile tissue. Neurosurgeons often rely on its flexibility and absorbability for controlling oozing from the dura mater and other delicate tissues within the cranial cavity.
Orthopedic surgeons use the material to manage bleeding in bony cavities or soft tissues during joint replacement and spinal procedures. It also finds application in specialized fields like otolaryngology and dental surgery for controlling capillary bleeding in mucosal surfaces and tooth extraction sites. The primary advantage is the ability to achieve localized hemostasis without the need for thermal cautery, which can damage surrounding healthy tissue, or extensive suturing in highly vascular areas.
Absorption and Dissolution in the Body
A significant feature of Oxidized Regenerated Cellulose is its design to be fully absorbed by the body without the need for a second surgical procedure to remove it. Once hemostasis is achieved, the material undergoes a natural breakdown process known as hydrolysis, initiated by the tissue fluids surrounding the implant site. This chemical process gradually breaks down the large cellulose polymer into smaller, water-soluble molecules, such as polyuronic acids. These breakdown products are then cleared from the tissue site and eliminated through normal metabolic pathways.
The time required for complete absorption typically ranges from seven to fourteen days, though this duration can vary based on the surgical site. Highly vascular sites with good blood flow, such as the kidney or liver, tend to clear the material faster due to increased fluid exchange. Conversely, less vascular areas or sites where a large amount of material was applied may take up to six weeks for full clearance.