Oxidized cellulose (Surgicel) based reaction post thyroidectomy mimicking an abscess: A case report

Royds, Janice A.; Kieran, Stephen; Timon, Conrad

doi:10.1016/j.ijscr.2012.03.034

Cited by 19 publications

(18 citation statements)

References 10 publications

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“…Royds et al [ 36 ] documented the first case of local tissue reaction associated with Surgicel ® in head and neck surgery, with removal and resolution confirming its cause. Concha et al [ 37 ] reported a case of xanthogranulomatous pyelonephritis caused by OC retention in a renal allograft, with consequent extirpation of the allograft and return to dialysis in a 41-year-old patient.…”

Section: Discussionmentioning

confidence: 99%

Practical Suggestions for Prevention of Complications Arising from Oxidized Cellulose Retention: A Case Report and Review of the Literature

et al. 2018

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Patient: Male, 51Final Diagnosis: Oxidised cellulose retainSymptoms: Abdominal pain • nausea • vomitingMedication: —Clinical Procedure: Laparoscopic abdominal exploration and drainageSpecialty: SurgeryObjective:Challenging differential diagnosisBackground:Bleeding is a major intraoperative complication during surgical procedures. When conventional methods such as ligature and diathermocoagulation are ineffective for bleeding management, hemostatic agents should be used. Oxidized cellulose is one of the major hemostatic agents used worldwide. Oxidized cellulose is often left in situ after hemostasis because of its high level of reabsorption that lasts up to 8 weeks. However, 38 cases of retaining-associated complications are reported in the literature.Case Report:A 51-year-old male patient presented in our emergency department with acute abdominal pain, nausea, and vomiting. The patient had been admitted in our department for laparoscopic cholecystectomy for acute cholecystitis 25 months previously. Abdominal ultrasound and CT scan showed the presence of a cystic circular mass, with homogeneous fluid content, close to the surgical clips of the previous surgery, resembling a “neo-gallbladder”. Laparoscopic abdominal exploration and drainage were performed. Histological examination reported protein-based amorphous material with rare lymphocytes and macrophages. Culturing was negative for bacterial growth. The patient was discharged uneventfully on the 4th postoperative day. The primary surgical report was evaluated with evidence of application of Gelita-Cel® Standard for hemostatic purposes. Results of 12-month follow-up were normal.Conclusions:Herein, we report the first case of a complication associated with the use of Gelita-Cel® Standard. We reviewed the literature to better define the purpose and limits of oxidized cellulose use as a hemostatic agent. Despite the fundamental role of oxidized cellulose as a hemostatic agent, we provide some practical suggestions to prevent the reported severe complications and surgical overtreatments.

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Section: Discussionmentioning

confidence: 99%

Practical Suggestions for Prevention of Complications Arising from Oxidized Cellulose Retention: A Case Report and Review of the Literature

et al. 2018

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“…They are designed to be left in situ after surgery. Reported events after the use of OCHAs may be broadly grouped into 3 categories: direct mass effects [5] , granuloma formation sometimes mimicking tumours [6] and pseudoabscess [7] . An earlier prospective study of Gelita-Cel OCHAs administered at mediastinoscopy suggested that the material was absorbed by day 14 [8] .…”

Section: Discussionmentioning

confidence: 99%

Foamy Macrophage Deposition in Lymph Nodes Mimicking Lung Cancer Recurrence Diagnosed via Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

Zhou

West²,

Shelley-Fraser³

et al. 2015

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static agents (OCHAs) during staging mediastinoscopy is common. We report a case of 18-fluorodeoxyglucose-avid subcarinal lymphadenopathy in a patient in whom OCHAs had been used at mediastinoscopy 5 months earlier. Histopathological examination of suspected nodal recurrence is facilitated by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). The technique is particularly useful after previous mediastinoscopy, when repeat surgical exploration can be challenging. EBUS-TBNA samples showed extensive foamy macrophage deposition, with no evidence of malignancy. The association between the use Key WordsFoamy macrophages · Oxidised cellulose haemostatic agents · Mediastinoscopy · Mediastinal lymphadenopathy · Endobronchial ultrasound-guided transbronchial needle aspiration AbstractThe radiological finding of mediastinal lymph node enlargement following surgery for lung cancer often signifies locoregional recurrence. The use of oxidised cellulose haemo-

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“…Advantages of surgicel as a hemostatic agent include its inertness, bio absorbability, no foreign body reaction and in-vitro antibacterial effects 67. Nevertheless literature suggests that surgicel can swell and increase in volume following saturation with blood thereby leading to mechanical compression on vital anatomical structures and radiographic artefacts mimicking abscesses and tumors in CT and ultrasonography 6202122232425…”

Section: Discussionmentioning

confidence: 99%

The effects of surgicel and bone wax hemostatic agents on bone healing: An experimental study

Nooh

Abdullah

Grawish

et al. 2014

IJOO

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Background:The biological effects of hemostatic agends on the physiological healing process need to be tested. The aim of this study was to assess the effects of oxidized cellulose (surgicel) and bone wax on bone healing in goats’ feet.Materials and Methods:Three congruent circular bone defects were created on the lateral aspects of the right and left metacarpal bones of ten goats. One defect was left unfilled and acted as a control; the remaining two defects were filled with bone wax and surgicel respectively. The 10 animals were divided into two groups of 5 animals each, to be sacrificed at the 3rd and 5th week postoperatively. Histological analysis assessing quality of bone formed and micro-computed tomography (MCT) measuring the quantities of bone volume (BV) and bone density (BD) were performed. The results of MCT analysis pertaining to BV and BD were statistically analyzed using two-way analysis of variance (ANOVA) and posthoc least significant difference tests.Results:Histological analysis at 3 weeks showed granulation tissue with new bone formation in the control defects, active bone formation only at the borders for surgicel filled defects and fibrous encapsulation with foreign body reaction in the bone wax filled defects. At 5 weeks, the control and surgicel filled defects showed greater bone formation; however the control defects had the greatest amount of new bone. Bone wax filled defects showed very little bone formation. The two-way ANOVA for MCT results showed significant differences for BV and BD between the different hemostatic agents during the two examination periods.Conclusion:Surgicel has superiority over bone wax in terms of osseous healing. Bone wax significantly hinders osteogenesis and induces inflammation.

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Oxidized cellulose (Surgicel) based reaction post thyroidectomy mimicking an abscess: A case report

Abstract: We present the first head and neck reaction to oxidized cellulose. This report serves to remind head and neck surgeons of the potential for local tissue reactions to this material.

Cited by 19 publications

References 10 publications

Practical Suggestions for Prevention of Complications Arising from Oxidized Cellulose Retention: A Case Report and Review of the Literature

Practical Suggestions for Prevention of Complications Arising from Oxidized Cellulose Retention: A Case Report and Review of the Literature

Foamy Macrophage Deposition in Lymph Nodes Mimicking Lung Cancer Recurrence Diagnosed via Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

The effects of surgicel and bone wax hemostatic agents on bone healing: An experimental study

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