Oxidized cellulose (Surgicel) is widely used for intraoperative hemostasis. When saturated with blood, Surgicel rapidly swells into a gelatinous mass. This property is particularly significant in a confined space containing neural tissue. Six cases of paraplegia following the use of oxidised cellulose in thoracic surgery have been reported.
Above - Hyperdense mass displacing and compressing the spinal cord
There have been several reports of neurological complications associated with the use of oxidized cellulose. There are six case reports of cord compression by a mass of this substance, causing paraplegia following thoracotomy. In all these cases, oxidized cellulose was used to control bleeding at the posterior end of a right T5-T6 interspace incision, in the region of the costo-transverse junction. Migration of an expanded mass of Surgicel through the adjacent intervertebral foramen into the epidural space caused significant cord compression.
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