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Uses of terramycin starch sponge and starch powder hemostatic
USES OF TERRAMYCIN STARCH SPONGE AND STARCH POWDER HEMOSTATIC A Preliminary
Report
IO.‘,8
l’twl’l?
1
.I .
I)l(‘O.Y%.\
I-pen prolonged soaking, starch sponpc tends to rcvt~rt to the gel state,. It is ltrokt~t~ down I)>- arnylascls. Absorption of’ starch sponge has h(hcn stt~diatl 1)). R~osenfeltl” and Kicchiuti.“~ I’; TZicchiuti I'c~untl absorption 01’ the spott’,l’t’ within twtattty-four hours arltl :I])front the peritoneal cavity ~otnplrte sorption Of snhcutatleous itllplilttts within sevcltlty-two hours. it1 espet’irrtents I ti another group oi’ fi v(’ with five mongrel dogs using phi11 stareIt spotigr. dogs, 025 grant of g~mttd starch sponge was sprinkletl into incisions, whic*h tiiiiror local (dcttia ()c(~~irr~~l iii t)oth i )I(’ vsperiwrrr rlosrd. In al I fi\-c ws(3 ‘1’11~~ cdrnta gradually clecreasccl and disappcarc~tl mental arid control wountls. by the ninth day. No differenct~ itt It(laling ltc~twcen thcx control aucl c~rpcrimerttal wounds was apparent and aftcir tttirty days the sc7trs could not hamdiflcarentiatctl 1)~ gross inspection; sections through t hc hcalcd ittcisions WWC~ncgativc t’ot. starch particles. No adhesions were SWTI in tli(l pc7itoneaI ca\itics of t ttrc~c~ uttintals studied by Ricrhiuti. I~ikYgc~piclcc4 0l’ dl*J- itIItl IV(si I)r. Boscnfeld made studies with rabbits. sponge were introduced among the intestinal roils. “.lt antopsy. gross irispc~eCon in t.he maj0rit.y of thclscb animals rerca Icd none’ ot trtitiimal wclhc?sions.“”
Suggested Trial Uses 1. I’ost-extrectintt (for hemorrhages disease. capillary ft3gilit.y. et?.) 2. Alveolectomy ii. Immediate denture trchtriqut~ 4. Gingivectomy 6. Soft tissue lesions (escisions floor of month, etc.1
in cases of tlial)etrs,
front lips. vrstihule
periotlontal
of ntouth. tottgue.
1. Postextraction.instanc~rs where it c~onstanl capillary seepage is evident post,operatively, whether it be after an extraction or any surgical pro~dure, the use of the starch powder impregnated with Terramycin has been quite effective. The powder is applied by means of a LIeVilbis insufflator made The area is kept, dry with one hand and expressly for use in the ot’itl cavity. ,\ cotton sponge is then n.pplictl the insufflator is cotttrolled with thr othtlr. with 1)t’essut’e f’~r it frw tttitiutrs. ITI other instances, where the bleeding may he t.oo profuse or the back l)t*essurr of the flow is t,oo st,rong, the starch sponge with Terrwmycitt tttay 1)~
It. is I)rittlr sul)st;ltlw bvhivh riltl 11~strilI)e~l 10 the soc*kct size I)y rlltt iIlK with ;I sc*:rI~wI. It is tlltbrl irlscbr+(b(l itrto ;I socket (II’ oI)er*ali\.c~ ;IW:I, il ~*011()11 sI)otlgt’ I)re~ionsl~ r~loiste~le(I xvii tr \~;rIer is ;lpl)litbcl o\.(‘I’ it, illl(l hel~l with
llsrtl.
il
]‘I’t’SSlil’(’
for.
il 1’t.W 1llillUtW.
2. Alveolectomy.-Most instances of per&tent capillar*~ seepage or bleediirg in tlicx line of incision or ahout snlur*es weavekept in ~ontr’ol I,- the rrse of the starch ~)owde’r~with ‘I’erxrlnyein, ;rI)l)Iietl 1)~ nleans of the insufflatc~r.
3. Immediate Denture Technique.--I’~~oIrahI~ the nrost satisfactory use 01 the star.ch I~owde~* with Te~*~arrryeirr IO control I~leetling is for the insedioll of :III irrrrnrtliate t1entnr.e. \vhether it he full 01’ I)adi:rl, 01 whether it he ;I sinll)Ie ol)etxti\-e pr~etlnre of extraction of teeth 01 the estrxdion of teeth foIlowN ly dvwlrcto1lly. In this l~r~xetlu~e we (aan eliminate the rise 01’ irtlhesivc tlentnre l~~wders. ant1 thus keel) unsterile Foreiyn rrrattet* out of all (I~K~U wound. The Te~~n~np~irr starach pow~ler is insnRIated on the prel~r~(I alvrc)l;lr ridge ant1 also in the tlentnr*e propet’; the tlenture is then inser.tetl, ant1 the hleetlin~ is arbrestetl. The staI*cah snhstan~e, in its ahsorption of’ l)r*irnar*> hleetling. for*rns a jellylike adhesive clot, whic*h aids in the retention of the tlenture. ant1 has an antibiotic eff’ect, as well. The :IWR. when \-ielvetl at SUM)sequent visits. is clean and firm, irrrtl healing is nneventfnl. 4. Gingivectomy.-7’el.i,irrrry~itr starch I~wder in this p~cetlure rnirlirnizes it etltirely. ant1 thns pilres iI tit,!: ;rreir 011 which to I)leetling or elirllini~trs ;~l)l)Iy OUL nredication 01 sut*yienI 1)ac.k. LIS
5. Biopsy.-The
tre:ttrnent here is the
hy means of insnfflation con~~~rrss is ailvisecl if needed.
a Was
ilIld
in
Soft
S>II~~
tissue
iIs
f’~r
ilI’Ci1S.
iI
socket in hnra(l tissne The applieafion of ir
6. Soft Tissue Lesions.-The liI)s at times may appear dry anti will yieltl point areas of bleeding that may interfere with some oper&ative pr*ocetlnres ; l~leetliri~ at the (dolnnrissures of the lips may 1~ cotltmllrd by using the irrsrtfflirtetl powder ils ;1 hernostntic. This rnethotl is l)errefieial in other, in;l(*c,cssiIrlc areas of the nionth. ;tlso
Case Reports Case 1.--A white wornan, aged 35 years, preseutetl herself with a history of repe:ite,l hospiialization for extractions, because of hemorrhage. Her experience promptetl her tcl seek hospitalizat~iou ljefore further extraction. In the previous year the area u-as suture(l after extraction hut postoperative seyuelae were discouraging. ecchymosis Severe (levelopetl that extended from the maxilla to the mandible. neck, clavicle. and sternum. Seeing the patient now for the first time, we suggested a l)lood picture. The followiug is the hematology report: H.H.C.. 1,1OO,OllO; W.H.P., !l,Wi); hemoglobin. X.3 per cent; I:! grams; color index, 1.0; differential count--I)ol~nnclear 63 per cent, band (stall) forms 2 per cent, lymphocytes (small and large) 32 per cent, monoc,vl,es 3 per cent; coagulation time, ten minutes; bleeding time. two minutes; clot retention, good in one hour; HumprlLee& ‘s test, + + ; platelets, 320,000; polychromasia, none ; stipplrtl cells, none; nnisocytoais, slight; poikilocytosis, slight; mieroc!tes. I+; macrocytes, none: norrtlol)lasts. none; rrlrgaloIjlasts. nour; hypochromia. slight.
Report
IO.‘,8
l’twl’l?
1
.I .
I)l(‘O.Y%.\
I-pen prolonged soaking, starch sponpc tends to rcvt~rt to the gel state,. It is ltrokt~t~ down I)>- arnylascls. Absorption of’ starch sponge has h(hcn stt~diatl 1)). R~osenfeltl” and Kicchiuti.“~ I’; TZicchiuti I'c~untl absorption 01’ the spott’,l’t’ within twtattty-four hours arltl :I])front the peritoneal cavity ~otnplrte sorption Of snhcutatleous itllplilttts within sevcltlty-two hours. it1 espet’irrtents I ti another group oi’ fi v(’ with five mongrel dogs using phi11 stareIt spotigr. dogs, 025 grant of g~mttd starch sponge was sprinkletl into incisions, whic*h tiiiiror local (dcttia ()c(~~irr~~l iii t)oth i )I(’ vsperiwrrr rlosrd. In al I fi\-c ws(3 ‘1’11~~ cdrnta gradually clecreasccl and disappcarc~tl mental arid control wountls. by the ninth day. No differenct~ itt It(laling ltc~twcen thcx control aucl c~rpcrimerttal wounds was apparent and aftcir tttirty days the sc7trs could not hamdiflcarentiatctl 1)~ gross inspection; sections through t hc hcalcd ittcisions WWC~ncgativc t’ot. starch particles. No adhesions were SWTI in tli(l pc7itoneaI ca\itics of t ttrc~c~ uttintals studied by Ricrhiuti. I~ikYgc~piclcc4 0l’ dl*J- itIItl IV(si I)r. Boscnfeld made studies with rabbits. sponge were introduced among the intestinal roils. “.lt antopsy. gross irispc~eCon in t.he maj0rit.y of thclscb animals rerca Icd none’ ot trtitiimal wclhc?sions.“”
Suggested Trial Uses 1. I’ost-extrectintt (for hemorrhages disease. capillary ft3gilit.y. et?.) 2. Alveolectomy ii. Immediate denture trchtriqut~ 4. Gingivectomy 6. Soft tissue lesions (escisions floor of month, etc.1
in cases of tlial)etrs,
front lips. vrstihule
periotlontal
of ntouth. tottgue.
1. Postextraction.instanc~rs where it c~onstanl capillary seepage is evident post,operatively, whether it be after an extraction or any surgical pro~dure, the use of the starch powder impregnated with Terramycin has been quite effective. The powder is applied by means of a LIeVilbis insufflator made The area is kept, dry with one hand and expressly for use in the ot’itl cavity. ,\ cotton sponge is then n.pplictl the insufflator is cotttrolled with thr othtlr. with 1)t’essut’e f’~r it frw tttitiutrs. ITI other instances, where the bleeding may he t.oo profuse or the back l)t*essurr of the flow is t,oo st,rong, the starch sponge with Terrwmycitt tttay 1)~
It. is I)rittlr sul)st;ltlw bvhivh riltl 11~strilI)e~l 10 the soc*kct size I)y rlltt iIlK with ;I sc*:rI~wI. It is tlltbrl irlscbr+(b(l itrto ;I socket (II’ oI)er*ali\.c~ ;IW:I, il ~*011()11 sI)otlgt’ I)re~ionsl~ r~loiste~le(I xvii tr \~;rIer is ;lpl)litbcl o\.(‘I’ it, illl(l hel~l with
llsrtl.
il
]‘I’t’SSlil’(’
for.
il 1’t.W 1llillUtW.
2. Alveolectomy.-Most instances of per&tent capillar*~ seepage or bleediirg in tlicx line of incision or ahout snlur*es weavekept in ~ontr’ol I,- the rrse of the starch ~)owde’r~with ‘I’erxrlnyein, ;rI)l)Iietl 1)~ nleans of the insufflatc~r.
3. Immediate Denture Technique.--I’~~oIrahI~ the nrost satisfactory use 01 the star.ch I~owde~* with Te~*~arrryeirr IO control I~leetling is for the insedioll of :III irrrrnrtliate t1entnr.e. \vhether it he full 01’ I)adi:rl, 01 whether it he ;I sinll)Ie ol)etxti\-e pr~etlnre of extraction of teeth 01 the estrxdion of teeth foIlowN ly dvwlrcto1lly. In this l~r~xetlu~e we (aan eliminate the rise 01’ irtlhesivc tlentnre l~~wders. ant1 thus keel) unsterile Foreiyn rrrattet* out of all (I~K~U wound. The Te~~n~np~irr starach pow~ler is insnRIated on the prel~r~(I alvrc)l;lr ridge ant1 also in the tlentnr*e propet’; the tlenture is then inser.tetl, ant1 the hleetlin~ is arbrestetl. The staI*cah snhstan~e, in its ahsorption of’ l)r*irnar*> hleetling. for*rns a jellylike adhesive clot, whic*h aids in the retention of the tlenture. ant1 has an antibiotic eff’ect, as well. The :IWR. when \-ielvetl at SUM)sequent visits. is clean and firm, irrrtl healing is nneventfnl. 4. Gingivectomy.-7’el.i,irrrry~itr starch I~wder in this p~cetlure rnirlirnizes it etltirely. ant1 thns pilres iI tit,!: ;rreir 011 which to I)leetling or elirllini~trs ;~l)l)Iy OUL nredication 01 sut*yienI 1)ac.k. LIS
5. Biopsy.-The
tre:ttrnent here is the
hy means of insnfflation con~~~rrss is ailvisecl if needed.
a Was
ilIld
in
Soft
S>II~~
tissue
iIs
f’~r
ilI’Ci1S.
iI
socket in hnra(l tissne The applieafion of ir
6. Soft Tissue Lesions.-The liI)s at times may appear dry anti will yieltl point areas of bleeding that may interfere with some oper&ative pr*ocetlnres ; l~leetliri~ at the (dolnnrissures of the lips may 1~ cotltmllrd by using the irrsrtfflirtetl powder ils ;1 hernostntic. This rnethotl is l)errefieial in other, in;l(*c,cssiIrlc areas of the nionth. ;tlso
Case Reports Case 1.--A white wornan, aged 35 years, preseutetl herself with a history of repe:ite,l hospiialization for extractions, because of hemorrhage. Her experience promptetl her tcl seek hospitalizat~iou ljefore further extraction. In the previous year the area u-as suture(l after extraction hut postoperative seyuelae were discouraging. ecchymosis Severe (levelopetl that extended from the maxilla to the mandible. neck, clavicle. and sternum. Seeing the patient now for the first time, we suggested a l)lood picture. The followiug is the hematology report: H.H.C.. 1,1OO,OllO; W.H.P., !l,Wi); hemoglobin. X.3 per cent; I:! grams; color index, 1.0; differential count--I)ol~nnclear 63 per cent, band (stall) forms 2 per cent, lymphocytes (small and large) 32 per cent, monoc,vl,es 3 per cent; coagulation time, ten minutes; bleeding time. two minutes; clot retention, good in one hour; HumprlLee& ‘s test, + + ; platelets, 320,000; polychromasia, none ; stipplrtl cells, none; nnisocytoais, slight; poikilocytosis, slight; mieroc!tes. I+; macrocytes, none: norrtlol)lasts. none; rrlrgaloIjlasts. nour; hypochromia. slight.