Oxidized regenerated cellulose in cardiac computer tomography imaging

Area of Science:

• Cardiovascular Surgery
• Radiology
• Biomaterials Science

Background:

• Oxidized regenerated cellulose (ORC) is a bioabsorbable hemostatic agent frequently used in surgery.
• Postoperative imaging of ORC materials can be challenging with standard modalities.

Observation:

• A patient developed superior vena cava obstruction after mitral valve repair due to mediastinal packing with Surgicel™ Nu-Knit™.
• Despite repeated imaging, the hemostatic material was not initially identified as the cause of the obstruction.

Findings:

• The ORC hemostatic agent was difficult to visualize on conventional radiography, CT, MRI, and sonography.
• Retrospective analysis indicated that earlier identification of the ORC was possible if radiologists were aware of its presence.

Implications:

• Surgeons must communicate the use of ORC hemostatic agents to radiologists.
• Improved radiologist awareness of ORC placement can enhance diagnostic accuracy and prevent delayed complications.
• This case highlights the importance of interdisciplinary communication in surgical patient care.