The efficacy of bi-component carboxymethylcellulose-polysaccharide B as a hemostatic and anti-adherent agent at the tibial insertion of the hamstring tendons after reconstruction of the anterior cruciate ligament

Abstract

Objective. The objective of this study is to evaluate and compare hemostatic and anti-adherent efficacy of the bi-component carboxymethylcellulose-polysaccharide B to the standard of electocauterization at the gracilis and semitendinosis harvest site in patients undergoing anterior cruciate ligament (ACL) reconstruction. Methods. In this randomized control trial, 32 patients undergoing ACL reconstruction were randomly divided into two groups. In group 1 (control), hemostasis was achieved via electrocoagulation at the gracilis and semitendinosis harvest site, and in group 2 (intervention) the bi-component was used to control bleeding at the same site. Results. There was no statistical difference between the groups in the pain assessments postoperatively, and the patients in group 2 had lower incidence of hematoma than the patients in group 1 on the first day postoperatively. There was a statistically significant difference between the groups in terms of postoperative range of motion (ROM) during the study period (p = 0.022). Patients in group 1 gained 17.8 degrees, patients in group 2 increased ROM by 34 degrees. No statistically significant difference was found in the incidence of hypoesthesia between the groups (p = 0.870). Conclusion. Bi-component carboxymethylcellulose-polysaccharide B showed better outcomes in terms of hematoma prevention and postoperative ROM than standard electrocoagulation in the immediate postoperative period for patients undergoing ACL reconstruction. Surgeons should consider using this compound to achieve hemostasis at the gracilis and semitendinosis harvest site during ACL reconstruction.

Innovative Eco-Friendly Hydrogel Film for Berberine Delivery in Skin Applications

“…In this work, an innovative, eco-friendly hydrogel, based on a mixture of polysaccharides and clays, has been developed to locally release berberine. Thanks to its biocompatibility, hydrophilicity, biodegradability, tissue resembling, pro-haemostatic properties and low cost [12][13][14][15], the sodium salt carboxymethyl cellulose (CMCNa) was used for the development of hydrogel films using gallium (Ga 3+ ) ions as crosslinkers. This approach represents a novelty in respect to the usual-often toxic-crosslinkers, such as covalent crosslinkers (i.e., carbodiimide crosslinkers, various glycidyl ethers, etc.…”

Experimental evaluation of the use of starch and carboxymethylcellulose in the prevention of intraperitoneal adhesions in hernia surgery with coated meshes

“…Carboxymethylcellulose is a low-molecular-weight and water-soluble cellulose product. It reduces adhesion and fibrosis formation by creating a film that works as a mechanical barrier, acting as a healing reorganization agent 26 . Starch is derived from plants and acts by dehydrating the blood.…”

“…In addition, this combination stimulates the production of tissue plasminogen activator by macrophages, which results in the conversion of plasminogen into plasmin, with consequent fibrinolytic action and decreased fibrin and adhesion formation 25 . Carboxymethylcellulose is quickly metabolized by human enzymes, and starch acts for approximately 40 days, generating a low risk of granulomatous reaction due to the short absorption period 26,28 .…”