Evaluation and comparison of structurally different cellulose-based hemostatic agents in a rat kidney model

Different topical hemostatic materials are used to achieve effective hemostasis. High hemostatic activity, biocompatibility, bioresorbability, and easy manipulation are to be expected in such a developed product. In the surgical world with these specific requirements, finding a proper hemostatic agent is very difficult. The study compared several materials of various construction properties, which were assessed for structural and related properties by morphological analyses and assessed in vivo for their efficiency and behaviour using a model of rat partial nephrectomy. New sodium salt of carboxymethyl cellulose (CMC) sponge with the lowest porosity and free swell absorptive capacity contained the highest amount of hydroxyl and carboxyl groups. Results revealed that this CMC material in the form of a bioresorbable sponge may ensure the necessary hemostatic effects, while also providing a positive influence on the reaction of the local tissue. The CMC material also needed significantly less time to achieve hemostasis (p < 0.001). Moreover, the sponge reached satisfactory results in the histopathological evaluation with the lowest destruction score and favorable healing reaction. This modified product proved itself to be a promising bioresorbable hemostat, which, according to its design, matches with its surgical applications. In general, the obtained data elucidated the dependency of the total effect on its structure and composition.