Medical sponge as a tool that has absorbent and antisepticproperties, as wellas stimulates tissue regeneration and isused in surgery, neurosurgery, dentistry, otolaryngology and gynecology to stop blood loss or to cose wound suracesburns, trophic ulcers). Hemostatic and dressing devices can be cassifled by various critena, including mechanism of action, wound type and mechanism of drug delivery. Also the hemostatic agents classified: by the mechanism of action, by the delivery mechanism, the form of the agent, the type ot wound. Currently, absorbent hemostatic products according to 21CFR 878.4490 classification "Absorbent heostatic agents and dressings" (FDA) are grouped under three commodity codes:
The most important feature of sponges that have pharmacological action is porosity; the porogen leaching techniqueprovides easy control of pore structure and well established inthe preparation of porous scaffolds for tissue engineering. Thistechnique involves the casting of a polymer/porogen composi-te by aqueous washing out of the incorporated poro-gen. The pore size, porosity and pore morphology easily con-trolled by the properties of porogen. Sodium chloride, sodiumhydrogen carbonate, ammonium bicarbonate particles are themost commonly used porogens.
The mechanism of action of hemostatic sponges is thecapture of platelets in a coagulation cascade, which activatedby the conversion of soluble fibrinogen into insoluble fibrin.which stops the bleeding. The physiological formation of thesame thrombin in the sponge is sufficient to stop bleeding, pre-cisely because of its effect on fibrinogen in the blood.
The use of absorbent materials is important in surgery, it isimportant for bleeding and for hemostasis in general. For exam.ple, the use of a dry sponge during surgery provides absorption of a large amount of fluid, and after surgery, such a sponge dissolves.
Currently, hemostatic and absorptive effects thought to relate to the porosity of the sponges and their ability to absorbblood or exudate from the wound surface, restore the integrityof the damaged vessels and accelerate the repair of damageotissues of the epidermis [16]. Absorbent/hemostatic spongecapable of absorbing large volumes of fluid in confined spacesand after easily removed.
The first medical sponges developed were based on colagen, gelatin, oxycellulose without additional coating or introduction of active pharmaceutical ingredients. Subsequentlythe sponges started coated with fibrinogen and thrombin toimprove their hemostatic efficacy and seal the tissues. Fibrinogen, thrombin, and synthetic or protein-reactive sealantcomponents are used as adhesive surface to the wound.New hemostatic sponges have recently been developed andused in surgical practice, such as collagen coated with polyethyleneglycol(PEG) or oxidized cellulose with PEG coating.
Thus, the sponge is a versatile form that can be filled withthe necessary active pharmaceutical ingredient, resulting in asuitable action, such as analgesic (with lidocaine hydrochloridenovocaine hydrochloride); anti-inflammatory (with diclofenacsodium,dimexide, methyluracil, prednisolone); hemostatic(with thrombin, calcium chloride, boric acid, calcium gluconate)
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