Hemorrhage

Encapsulation of fluid and foreign body reactions with or without infection have been reported

Possible prolongation of drainage in cholescytectomies and difficulty in passing urine per urethra
after prostaectomy have been reported

Burning reported when applied after nasal polyp removal and after hemorrhodectomy

Headache, burning, stinging, and sneezing in epitaxis and other rhinological procedures and
stinging when applied on surface wounds ( varicose ulcerations, dermabrasions and donor sites)
have also been reported

Miscellaneous- necrosis of nasal membrane or perforation of nasal septum due to tight packing,
urethral obstruction following retropubic praostatecomy and introduction of oxidase cellulose
within enucleted prostratic capsule.

Packing or wadding of hemostatic agent, packing or implantation in fractures or laminectomies

Special Precautions-
Steriization- do not autoclave, autoclaving causes physical breajdown

Surgery - not intended as a substitute for careful surgery and proper  use of sutures and ligatures

Contaminated wound- closing oxidized cellolose in a contaminated wound without drainage
may lead to complications and should be avoided.

Application removal - the hemostatic effect is greater when applied dry, therefore, do not moisten
with water or saline.  Do not impregnate with materials such as buffering or hemostatic substances.
Its hemostatic effect is not enhanced by addition of thrombin.

May be left in situ when necesary but remove it once hemostatic is acheived. It must always
be removed if used in, around or in proximity to foramina in bone, areas of bony confine.

Infections- it is a systemic antimicrobial agents to control or prevent  posoperative
infections. Do not impregnate with antiinfective agents.

Packing- apply by loosely packing against the bleeding surface . Avoid wadding or packing tightly,
especially within the bony enclosure of the CNS and within other relatively rigid cavities where
swelling may interfere with the normal function or possibly cause necrosis.

Use sparingly- to control bleeding in open reduction of fractures and in cancellous bone, use sparingly
To minimise the possibilty of interfernce with callous formation and theoritical chance of cyst formation
remove any excess after bleeding is controlled.

Urological procedures-  use minimal amounts and excercise care to prevent plugging of the urethra,
ureter or catheter

Otorhinolaryngologic surgery- excercise care so that none of the material is aspirated by the patient
(eg when controlling hemorrhage after tonsillectomy , controlling epistaxis)

Indication-
Hemorrhage

Dosage-
Withdraw hemostat from the container with dry sterile forceps. Minimal amounts of an appropriate
size are laid on the bleeding site or held firmly against  the tissues until hemostatis is obtained.

Pharmacology-
An absorbable hemostatic agent prepared from cellulose by a special process that converts  it
into ployhyroglucuronic acid (cellulosic  acid ) . Oxidation of cellulose yields an absorbable
product of known  acidity, soluble in akali.