CASE REPORT Use of Oxidized Regenerated Cellulose to Stop Bleeding After a Facelift Procedure Franco Bassetto Æ Vincenzo Vindigni Æ Carlotta Scarpa Æ Chiara Botti Æ Giovanni Botti Received: 24 April 2008 / Accepted: 3 June 2008 / Published online: 1 July 2008 Ó Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2008 Abstract A 52-year-old woman came to our department about correcting a severe soft-tissue laxity after a weight loss of 67 kg. We performed a deep-plane face lift under sedation with local anesthesia. Three hours after the operation the patient had significant and diffuse bleeding, which was controlled by a local hemostatic agent made of oxidized regenerated cellulose (Tabotamp Ò ). In the weeks after the operation no local pain or skin damage was observed. We believe that oxidized regenerated cellulose could be a good ancillary therapy for controlling local bleeding associated with this kind of surgery. Keywords Face lift Á Hematoma Á Oxidized regenerated cellulose Á Hemostatic agent Hematoma is the most frequent complication after rhyti- dectomy with a reported incidence of 0.3–15% [1]. There have been many studies to determine the main factors involved in hematoma formation such as the patient’s gender; whether the patient has hypertension; type of anesthesia used; preoperative, intraoperative, and postop- erative blood pressure; preoperative, intraoperative, and postoperative medications; and the type of rhytidectomy performed [1, 2]. There are many treatments and devices such as intu- mescent anesthesia, drains, fibrin glue, and compressive dressings [2–5] that may stop bleeding, thus avoiding hematoma collection. In this report we describe our per- sonal experience with oxidized regenerated cellulose (Tabotamp Ò , Johnson & Johnson, Italy) in a case of bleeding and subsequent hematoma after rhytidectomy. Tabotamp was developed in 1960 from wood pulp, and it is used especially in general and vascular surgery to avoid or control postoperative bleeding. Case Report A 52-year-old woman was admitted to our department after a significant and rapid weight loss of 67 kg (Fig. 1a–c). The preoperative evaluation showed an aging face with loss of the vertical vectors characteristic of a young face. The blood tests showed a PT reduction considered non- significant from an anesthesiologic point of view. We performed a face lift with SMAS embrication (Fig. 2a), for better and longer-lasting results, under local anesthesia with sedation. The local anesthetic injection was mepiva- caine with epinephrine 1:300,000 to reduce intraoperative bleeding. Intraoperatively blood pressure was mantained at 100/ 70 mmHg. We performed an accurate hemostasis throughout the whole area of undermining and employed easy-flow drains to allow for evacuation of any incidental postoperative serosanguinous collection. In the first 12 h we prescribed clonidin 1 fl/100 ml NaCl 0.9% to maintain low blood pressure and we used compressive bandages. Three hours postoperatively we noticed the presence of a voluminous, painful, and taut hematoma around the pre- and retroauricular regions (Fig. 2b). We therefore decided to remove the sutures to verify the hemostasis. We found diffuse bleeding that could not be attributed to any specific F. Bassetto Á V. Vindigni Á C. Scarpa (&) Unit of Plastic and Reconstructive Surgery, University of Padova, Via Giustiniani, 2-35100 Padova, Italy e-mail: carlotsc@tin.it; carlotsc@libero.it C. Botti Á G. Botti Villa Bella Clinic, Salo, BS, Italy 123 Aesth Plast Surg (2008) 32:807–809 DOI 10.1007/s00266-008-9203-1