A Comprehensive Review of SURGICEL®: Efficacy, Applications, and Radiological Insights in Surgery
Dia R Halalmeh1,2, HusamEddin Z Salama2, Yusuf-Zain Ansari3,2
1Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, USA.
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SURGICEL® is a widely used hemostatic material designed to control capillary, venous, and small arterial bleeding. Introduced in 1960, it functions by producing cellulosic acid, which promotes platelet aggregation and activation of the coagulation pathway. This bioabsorbable material has been utilized in various surgical procedures to manage perioperative bleeding. The objective of this article is to review the mechanism of action, clinical applications, and imaging characteristics of SURGICEL®, as well as its role in differential diagnosis in surgical contexts. This article serves as a comprehensive review of SURGICEL® in various surgical fields, including neurosurgery, urology, orthopedics, and maxillofacial surgery, while also examining SURGICEL®'s hemostatic mechanism, clinical efficacy, and bioabsorbable properties. The review also evaluates its radiological appearance in ultrasound, CT, and MRI, and addresses its role in differential diagnosis and potential complications, such as granuloma formation and infections, based on existing literature. SURGICEL® has proven effective in achieving hemostasis in a wide range of surgical procedures, including maxillofacial and neurosurgical operations. As a bioabsorbable material, it induces minimal tissue reactions and is gradually absorbed over time. On imaging, it appears as echogenic masses, radiopaque bands, or alterations in signal intensity, particularly on MRI. MRI can differentiate SURGICEL® from adjacent tissues, aiding in the identification of hematoma-like masses or complications such as granulomas and infections. Overall, SURGICEL® offers significant utility in surgical hemostasis with minimal side effects. However, careful monitoring is required to avoid complications, and knowledge of its radiological appearance is essential for accurate differential diagnosis. This review highlights its coagulation-promoting properties, imaging features, and potential complications to guide its effective clinical use.

