New Hemostatic Powder (GelitaCel Ca Powder<sup>TM</sup>) and Its Application in Cranial Neurosurgery

Abstract

Background: Intraoperative hemostasis during intracranial surgery is one of the most important aspects of the surgical procedure. One of the most widely practiced methods to prevent postoperative hemorrhage is to cover the cerebral wound bed with cellulose. Objective: We report on the use of a new powder form of regenerated oxidized cellulose enriched with calcium (GelitaCel Ca Powder™, Gelita Medical, Eberbach, Germany) for hemostasis purposes in intracranial surgery. Methods: In 107 patients operated for intracranial mass lesions, the resection cavity was covered with a small layer of cellulose powder for hemostatic purposes. All patients had a postoperative CT or MRI scanning within 24 hours after surgery to detect any surgical complications and to detect the presence of blood within the surgical cavity. Results: Of the 107 operated patients, 96 (90%) had no or minimal blood in the intracranial resection field on postoperative imaging with CT or MRI. Of those 96, 69 patients had no blood at all and 27 patients had a small trace. In the remaining 11 patients, 8 patients (7.5%) had blood filling the resection cavity. In three patients (2.8%), the blood accumulation resulted in mass effect. All these three patients were re-operated due to neurological deterioration. Conclusion: We suggest that cellulose powder is an easy and safe product for hemostasis and prevention of postoperative hemorrhage in intracranial surgery. The main advantage of the powder form over regular oxidized cellulose is the no-touch technique of application and leaves no excess hemostatic material behind which could possibly cause compression.