Surgical Hemostat Comprising Oxidized Cellulose

This invention relates to surgical hemostats for control of bleeding, and more particularly, to a knitted fabric of oxidized cellulose having superior handling and hemostatic properties.

The control of bleeding is a serious problem in certain surgical procedures and in various types of emergency wounds. Bleeding from the kidney, brain or liver or the persistent oozing from severed capillaries and veins, for example, is particularly difficult to control by conventional means such as suturing or ligature, and in many cases, is serious enough to endanger life. Surgical hemostats consisting of conventional gauze pads or similar articles impregnated with a hemostatic material such as ferric chloride, thrombin or the like have been used for many years to arrest bleeding. Hemostats of this type cannot be left in a closed wound, however, since foreign body tissue reaction would result.

Absorbable hemostatic materials have been developed which may be left in a wound site, if necessary, to control bleeding and will be eventually absorbed by the body without adverse tissue reaction. Such absorbable materials include the polymers and copolymers of lactide and glycolide, and oxidized cellulose. The preparation and use of oxidized cellulose as an absorbable heostat is disclosed in U.S. Pat. No. 3,364,200, the teachings of which are specifically incorporated herein by reference.

Briefly stated, U.S. Pat. No. 3,364,200 discloses the preparation of oxidized cellulose by treating bright rayon regenerated cellulose with an oxidizing agent such as dinitrogen tetroxide in a Freon medium. After oxidation, the fabric is thoroughly washed with a solvent such as carbon tetrachloride followed by aqueous solution of 50 percent isopropyl alcohol and finally, with 99 percent isopropyl alcohol. Prior to oxidation, the hemostat is constructed in the desired form such as a gauze, knit, woven fabric, felt or integrated mass of staple fibers. Example 1 of U.S. Pat. No. 3,364,200 describes the preparation of a hemostatic surgical gauze from 1.6 denier continous filament bright rayon. The rayon is first converted into a 90 filament, 150 total denier yarn and, thereafter, knitted on a Wildman 28 cut, spring needle knitting machine into a fabric of plain jersey construction having a weight of about 1 pound per 13 square yards and a count of 18 courses and 18 wales per linear inch.

The knit jersey fabric prepared according to the teachings of U.S. Pat. No. 3,364,200, particularly Example 1 thereof, is a lightweight open mesh material which conforms nicely to the surface configuration of the wound site and is effective in controlling bleeding. The present invention, however, is directed to an improved hemostatic material, also constructed of oxidized cellulose, which is more efficacious in controlling bleeding than the material of U.S. Pat. No. 3,364,200 and has other improved properties as well.

The absorbable hemostatic materials of the present invention are warp knitted tricot fabrics constructed of bright rayon yarn which is subsequently oxidized by known techniques. The fabrics are characterized by having a single ply thickness of at least 0.5 mm, a density of at least 0.03 g/cm.sup.2, air porosity of less than 150 cm.sup.3 /sec/cm.sup.2 and liquid absorption capacity of at least 3 times the dry weight of the fabric and at least 0.1 water per cm.sup.2 of the fabric at least 0.09 g water per cm2 of the fabric.

The knit fabrics of the present invention have good bulk without undue weight, are soft and drapable, conforming well to the configuration of the surface to which they are applied. The fabric may be cut into suitable sizes without running or fraying along the cut edge. Fabric strength after oxidation is more than adequate for use as a surgical hemostat.

The hemostatic properties of the fabric of the present invention are superior to those of the prior art knit fabrics. In addition, the increased bulk of the fabric of the instant invention allows the fabrics to be used singly-ply rather than folded as is necessary with the prior art fabrics.

The improved hemostatic fabrics of the present invention comprising oxidized cellulose are best characterized by their physical properties of thickness, bulk, porosity and liquid absorption capacity as recited above. Suitable fabrics having these properties may be constructed by knitting 60 denier, 18 filament bright rayon yarn on a 32 gauge machine at a knit quality of 12. A suitable tricot fabric construction is front bar 1-0, 10-11; back bar 2-3, 1-0. The extended shog movement imparted to the front bar results in a 188 inch runner compared to a 70 inch runner for the back guide bar and increases the fabric bulk and density. The ratio of front to back bar runners in this particular construction is 1:2.68.

The physical properties and the hemostatic efficacy of the fabric produced as above described were compared to those of the prior art knit fabric described in Example 1 of U.S. Pat. No. 3,364,200 with the following results:

The tricot fabrics of the present invention may be constructed from bright rayon yarns of from about 40 to 80 total denier. Each yarn may contain from 10 to 25 individual filaments although each individual filament is preferably less than 5 denier to avoid extended absorption times.

The high bulk and fabric density are obtained by knitting at 28 gauge or finer, preferably at 32 gauge, with a fabric quality of about 10 or 12 (40 to 48 courses per inch). A long guide bar shog movement of at least 6 needle spaces, and preferably 8 to 12 spaces, further increases fabric thickness and density.

Other warp knit tricot fabric constructions which produce equivalent physical properties may, of course, be utilized in the manufacture of the improved hemostatic materials of the present invention, and such constructions will be apparent to those skilled in the art.