Methods of Hemostasis and Using of Oxidized Recovered Cellulose Agents in Partial Nephrectomy

Kachmazov A.A., Zhernov A.A.

In past radical nephrectomy was a method of choice in treatment of renal tumors, but recent successes clearly demonstrated advantages of renal-preserving surgical tactics in cases of tumor small size. Partial nephrectomy in patients with renal tumors, both open and laparoscopic, received wide recognition as an alternative to radical nephrectomy. In case of expansion of indications for partial nephrectomy secure methods of tumor resection and prevention of postoperative complications should be developed. In this respect haemostatic material from oxidized recovered cellulose (ORC) demonstrated itself as a high-effective and simple handled agent in prevention of postoperative bleeding and infectious complications. In acid environment thrombocytes and hemolyzed, hemin extracted erythrocytes play the role of supporting frame to the formation of platelet clot. Acid environment creates conditions for ORC intensive antibacterial activity including drug-resistant microorganisms due to lower pH effects on a wide range of bacteria and non-specific mechanism of action. Special attention should be payed to most common gram-positive infectious agents: aurococcus, coagulase-negative staphylococcus and enterococcus. ORC's (Surgicel Original, Surgicel Nu- Knit, Surgicel Fibrillar) haemostatic activity accomplished by proven in vitro and in vivo antibiotic activity makes its routine using in urology reasonable.

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