Patient’s Journey: Total Knee Replacement Surgery
Patient’s Journey: Total Knee Replacement Surgery

Dr. James E. Dowd discusses the benefits of Topical Skin Adhesives versus staples with his patient, Diane McGaw, who describes her healing and cosmetic outcome six weeks post-surgery. 

Shaping the Future of Surgery

Over a Century of Meaningful Innovation

At Ethicon, weʼre focused on improving health outcomes for patients and helping solve the greatest health challenges… with only meaningful innovation. The kind that led to the creation of the first sutures, that helped revolutionize surgery with minimally invasive procedures, and that elevates standards of care around the world.

News & Events
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Ethicon Announces 510(K) Clearances for VISTASEAL Open and Laparoscopic Dual Applicator Devices Designed to Deliver Biologics That Address Surgical Bleeding
VISTASEAL Dual Applicator is the First Product to Emerge from Recent Strategic Partnership Between Ethicon and Grifols, Leading Maker of Plasma-Derived Medicines
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Pulmonary Artery Branch Sealing with Ultrasonic Energy Device Shows Promise in Minimally Invasive Lung Cancer International Clinical Trial
Preliminary Findings Presented at American Association for Thoracic Surgery Annual Meeting
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LINX Reflux Management System Has Been Shown to Reduce Medical Costs More Than Traditional Anti-Reflux Surgery in First Year Following Procedure
New Study Shows LINX treatment Lowers Overall Medical Expenses for GERD and other Health Issues
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Ethicon Launches Global Registry to Collect Real-World Data on Liver Lesions Ablated With the Neuwave Microwave Ablation System
References

‡ Refers to STRATAFIX™ devices with Plus Antibacterial Technology only

1. Lissovoy, G. D., Fraeman, K., Hutchins, V., Murphy, D., Song, D., & Vaughn, B. B. (2009). Surgical site infection: Incidence and impact on hospital utilization and treatment costs. American Journal of Infection Control, 37(5), 387-397.

2. Ming X, Rothenburger S, Nichols MM. In vivo and in vitro antibacterial efficacy of PDS Plus (polidioxanone with triclosan) suture. Surg Infect (Larchmt). 2008;9(4):451-457.

3. Ming X, Rothenburger S, Nichols MM, Rothenburger S. In Vivo Antibacterial Efficacy of MONOCRYL Plus Antibacterial (Poliglecaprone 25 withTriclosan) Suture. Surg Infect (Larchmt). 2007; 8(2):1-5.

4. Rothenburger S, Spangler D, Bhende S, Burkley D. In vitro antimicrobialevaluation of coated Vicryl Plus Antibacterial Suture (coated polyglactin 910 with triclosan) using zone of inhibition assays. Surg Infect (Larchmt). 2002;3 (suppl):S79-S87.

5. Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. doi:10.1001/jamasurg.2017.0904.

6. WHO Global Guidelines for the Prevention of Surgical Site Infection, 2016.

7. Ban KA, Minei JP, Laronga C, et al. American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. J Am Coll Surg. 2016;224:59-74. 

8. Nett M, Avelar R, Sheehan M, Cushner F. Water-tight knee arthrotomy closure: comparison of a novel single bidirectional barbed self-retaining running suture versus conventional interrupted sutures. J Knee Surg. 2011;24:55-59.

9. Shikanov S, Wille M, Large M, Lifshitz DA, Zorn KC, Shalhav AL, Eggener SE. Knotless closure of the collecting system and renal parenchyma with a novel barbed suture during laparoscopic porcine partial nephrectomy. J Endurology. 2009;23:1157-1160.

10. Su 06TR071, Study Report for in vitro evaluation of microbial barrier properties of DERMABOND ProTape. Ethicon, Inc.

11. 100326296: Time Zero Tissue Holding - Competitive Claims Comparisons for STRATAFIX Knotless Tissue Control Devices vs Various Products. 2015.

12. Performance Testing of STRATAFIX SYMMETRIC PDS PLUS Size 0 & 1 Devices – Initiation Strength in Porcine Tissue. AST-2013-0603. 

13. AST-2013-0056 Performance Testing of STRATAFIX Symmetric PDSSize2-0 suture device for Tissue Holding Strength with Multiple Incision Defects to Measure Gapping.

14. Ethicon study PSE 09-0204, project number 11822. Exploratory histological and biomechanical evaluation of DOLFIN following closure of the ventral abdominal wall in a porcine model at 7±1 days. Approved on July 7, 2010. 

15. Ethicon Performance Evaluation Memo AST-2012-0510. Performance Testing of STRATAFIX Symmetric Size 2-0 suture device for Tissue Holding Strength with an Incision Defect to Measure Gapping. Dated December 3, 2012. 

16. STRATAFIX Symmetric PDS Plus Knotless Tissue Control Device. Instructions for Use. Ethicon, Inc. 

17. Directions Research. PRINEO Claims Exploration US Patient & Surgeon Reference Data. 2017.

18. DERMABOND™ PRINEO™ Skin Closure System Instructions for Use. Ethicon, Inc.

19. Coated VICRYL Plus Antibacterial (polyglactin 910) Sutures Instructions for Use. Ethicon, Inc. 

20. Ethicon Wound Closure Manual. 2007. Ethicon, Inc.

21. Bloemen A, van Dooren P, Huizinga BF, Hoofwijk AGM. Randomized clinical trial comparing polypropylene or polydioxanone for midline abdominal wall closure. Br J Surg. 2011;98:633-639.

22. US Market Share Report, October 2016. Ethicon, Inc.

23. SURGICEL® Technical Report, 2018. Ethicon, Inc.  

24. Hong YM, Loughlin KR. The use of hemostatic agents and sealants in urology. J Urol. 2006;176(6 Pt 1):2367-2374.

25. SURGICEL® Absorbable Hemostat. Full Prescribing Information. Ethicon, Inc. 

26. Ethicon retrospective analysis of economic and clinical outcomes comparing the use of Echelon Powered vs. Medtronic non-powered endoscopic surgical staplers to treat patients undergoing video-assisted thoracoscopic surgery lobectomy.Review of 3,006 cases between 2012 and 2015 from the Premier Perspective® Hospital Database. Data assessed included length of stay, total hospital cost, supply cost, room & board cost, incidence of transfusion, and incidence of hemostasis-related complications; all p ≤ 0.05.

For complete indications, contraindications, warnings, precautions, and adverse reactions, please reference full package insert.

 

SURGICEL Essential Product Information

INDICATIONS
SURGICEL® Absorbable Hemostat (oxidized regenerated cellulose) is used adjunctively in surgical procedures to assist in the control of capillary, venous, and small arterial hemorrhage when ligation or other conventional methods of control are impractical or ineffective. SURGICEL® ORIGINAL, SURGICEL® FIBRILLAR™, SURGICEL® NU-KNIT®, and SURGICEL® SNoW™ Absorbable Hemostats can be cut to size for use in endoscopic procedures.

PRECAUTIONS
Use only as much SURGICEL® Absorbable Hemostat as is necessary for hemostasis, holding it firmly in place until bleeding stops. Remove any excess before surgical closure in order to facilitate absorption and minimize the possibility of foreign body reaction.

In urological procedures, minimal amounts of SURGICEL® Absorbable Hemostat should be used and care must be exercised to prevent plugging of the urethra, ureter, or a catheter by dislodged portions of the product.

Since absorption of SURGICEL® Absorbable Hemostat could be prevented in chemically cauterized areas, its use should not be preceded by application of silver nitrate or any other escharotic chemicals.

If SURGICEL® Absorbable Hemostat is used temporarily to line the cavity of large open wounds, it should be placed so as not to overlap the skin edges. It should also be removed from open wounds by forceps or by irrigation with sterile water or saline solution after bleeding has stopped.

Precautions should be taken in otorhinolaryngologic surgery to assure that none of the material is aspirated by the patient. (Examples: controlling hemorrhage after tonsillectomy and controlling epistaxis.)

Care should be taken not to apply SURGICEL® Absorbable Hemostat too tightly when it is used as a wrap during vascular surgery (see Adverse Reactions section of the complete product package insert).

ADVERSE EVENTS
“Encapsulation” of fluid and foreign body reactions have been reported.

There have been reports of stenotic effect when SURGICEL® Absorbable Hemostat has been applied as a wrap during vascular surgery.

Paralysis and nerve damage have been reported when SURGICEL® Absorbable Hemostat was used around, in, or in proximity to foramina in bone, areas of bony confine, the spinal cord, and/or the optic nerve and chiasm.

Blindness has been reported in connection with surgical repair of a lacerated left frontal lobe when SURGICEL® Absorbable Hemostat was placed in the anterior cranial fossa.

Possible prolongation of drainage in cholecystectomies and difficulty passing urine per urethra after prostatectomy have been reported.

For more information, please consult your doctor or for product quality and technical questions, call 1-800-795-0012. For complete product information including indications, contraindications, warnings, precautions, and adverse reactions, please reference the individual product package inserts.

SURGICEL® Powder Absorbable Hemostat Essential Product Information

INDICATIONS
SURGICEL® Powder (oxidized regenerated cellulose) is used adjunctively in surgical procedures to assist in the control of capillary, venous, and small arterial hemorrhage when ligation or other conventional methods of control are impractical or ineffective.

CONTRAINDICATIONS
Do not inject or place SURGICEL® Powder into an open blood vessel. Do not use to treat bleeding from large defects in arteries or veins.

SURGICEL® Powder should not be used to control hemorrhage from large arteries or veins.

When SURGICEL® Powder is used to help achieve hemostasis in, around, or in proximity to foramina in bone, areas of bony confine, the spinal cord, or the optic nerve and chiasm, it must always be removed after hemostasis is achieved since it will swell and could exert unwanted pressure.

SURGICEL® Powder should not be used for implantation in bone defects, such as fractures, since there is a possibility of interference with callus formation and a theoretical chance of cyst formation.

WARNINGS
Closing with SURGICEL® Powder in a contaminated wound without drainage may lead to complications and should be avoided.

SURGICEL® Powder should not be impregnated with anti-infective agents or with other materials such as buffering or hemostatic substances. 

SURGICEL® Powder is dry and there may be difficulties in precise delivery under certain circumstances. Unintentional device placement may result in powder scattering and device migration that may increase the risk of adhesion formation. 

Although SURGICEL® Powder is bactericidal against a wide range of pathogenic microorganisms, it is not intended as a substitute for systemically administered therapeutic or prophylactic antimicrobial agents to control or to prevent postoperative infections.

Do not attempt to trim the applicator tip.

PRECAUTIONS
SURGICEL® Powder should not be used in conjunction with autologous blood salvage circuits, because its fragments may pass through the transfusion filters of blood-scavenging systems.

Use only as much SURGICEL® Powder (oxidized regenerated cellulose) as is necessary and apply only where needed for hemostasis. Remove any excess before surgical closure in order to facilitate absorption and to minimize the possibility of foreign body reaction.

In urological procedures, minimal amounts of SURGICEL® Powder should be used and care must be exercised to prevent plugging of the urethra, ureter, or a catheter by dislodged portions of the product.

Since absorption of SURGICEL® Powder could be prevented in chemically cauterized areas, its use should not be preceded by application of silver nitrate or any other escharotic chemicals.

If SURGICEL® Powder is used temporarily to line the cavity of open wounds, it should be removed by irrigation with sterile water or saline solution after bleeding has stopped.

Precautions should be taken in otorhinolaryngologic surgery to ensure that none of the material is aspirated by the patient (e.g., controlling hemorrhage after tonsillectomy and controlling epistaxis).

This applicator tip is not intended for laparoscopic or other endoscopic use.

ADVERSE EVENTS 
Paralysis and nerve damage have been reported when other SURGICEL® products were used around, in, or in proximity to foramina in bone, areas of bony confine, the spinal cord, and/or the optic nerve and chiasm. 

Blindness has been reported in connection with surgical repair of a lacerated left frontal lobe when other SURGICEL® products were placed in the anterior cranial fossa (see WARNINGS and PRECAUTIONS).

Foreign body reactions have been reported with other products from the SURGICEL® Family of Absorbable Hemostats.

Burning has been reported when other SURGICEL® products were applied after nasal polyp removal. Headache, burning, stinging, and sneezing in epistaxis and other rhinological procedures, and stinging when SURGICEL® product was applied on surface wounds (varicose ulcerations, dermabrasions, and donor sites) have also been reported.

For more information and technical questions, call 1-800-795-0012.  For complete information including indications, contraindications, warnings, precautions, adverse reactions, and directions for use, consult the product package insert.