Hemostasis with WoundClot Hemostatic Gauze in Orthopedic Oncology Surgery

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The subspecialty of orthopedic oncology is concerned with the diagnosis and treatment of musculoskeletal tumors, both primary and secondary, both benign and malignant. Nearly 50 types of procedures, ranging from short biopsies to lengthy 12 hour hemi-pelvectomies, are performed by orthopedic oncologists. They can require significant neurovascular dissection, removal of substantial bone and muscle, replacing large sections of bone with cement or 3D-printed prostheses, or total joint replacement. Patients who undergo orthopedic oncologic surgery often have received substantial medical treatment prior to surgery. Chemotherapy or radiation therapy can result in anemia and thrombocytopenia. In addition to these side effects, there may be significant co-morbidities.

In general, because tumors are fairly vascular structures, they are susceptible to bleed throughout the surgery. Systemic ejects of the tumor and chemotherapy and radiotherapy also contribute to the preponderance for the bleeding. In particular, renal cell and thyroid metastases, with marked neovascularization to affected areas, frequently hemorrhage considerably during surgery, more so than other forms of osseous metastasis.

60% of spinal metastasis, 40% of benign primary spinal neoplasms, and 85% of all malignant primary spinal neoplasms are hyper vascular. In addition to renal and thyroid metastasis, other examples of highly vascular tumors prone to bleeding include breast carcinoma, prostate carcinoma, hemangiomas, aneurysmal bone cysts, melanomas, osteoblastomas, osteosarcomas, and giant cell tumors [2]. Some independent indicators of major bleeding include the procedure type, cancer type, female patients and co-existing coronary artery disease or chronic obstructive pulmonary disease.

The WoundClot gauze is seen in situ following removal of the osteoid osteoma in the distal humerus.

WoundClot hemostatic gauze comprises a complete new hierarchy of material engineering from its molecular level, through optimization of its physical properties, interaction with blood and maximization of its clotting promotion capabilities. Its unique biocompatibility effectively solves the major thromboembolism problem demonstrated by the other major hemostatic dressings over long term use. As a simple to use, versatile, non-compressional hemostat, WoundClot finally provides a new and improved solution to the clinical problem of uncontrolled hemorrhage for virtually all pre hospital civilian and military hemorrhaging trauma, as well as in the operating room and post-surgical applications. Additionally, WoundClot is a cost-effective solution to the many applications just mentioned; its low cost point is comparable or better than other hemostatic products.

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Journal of Health Policy & Management.
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