Presenting SURGICEL Powder

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SURGICEL Powder Presenting SURGICEL Powder Built to stop continuous, broad-surface oozing fast1,2

The next generation of SURGICEL Absorbable Hemostats SURGICEL Powder efficiently and effectively controls continuous oozing on broad surfaces 1,2 Ready to use out of the package, with no preparation required 3 Penetrates blood quickly to stop broad-surface oozing right at the source 1,2,4 After hemostasis has been achieved, the source will not rebleed even if SURGICEL Powder is irrigated 2 * Everything you ve come to expect from the SURGICEL Family of s Proven in vitro bactericidal activity against five common hospital- acquired pathogens (MRSA, MRSE, VRE, PRSP, E coli) 5-7 Fully absorbable within 7 to 14 days 8,9 Contains an aggregate of ORC fiber fragments that help control capillary, venous, and small arterial hemorrhages 2,5 Precise delivery control regardless of device orientation 10 Efficient Aspiration: Provides consistent dosage per application for minimal wasted product10 Flexible Tip: The flexible tip on the applicator allows for aspiration in any direction or orientation in open procedures. *Based on preclinical testing in a swine acute liver biopsy model

SURGICEL Family of s One family. Five products. 50+ years. SURGICEL Original SURGICEL FIBRILLAR SURGICEL Powder SURGICEL SNoW SURGICEL NU-KNIT Trust 50+ years of proven safety, efficacy, and in vitro bactericidal properties Versatile Easily separated layers are customizable, allowing for precise placement Broad Coverage continuous oozing on broad surfaces Innovative hemostasis with better conformability, handling and adherence to tissue* Strength High tensile strength and thickness allow it to hold suture The SURGICEL Family provides a breadth of solutions for all continuous oozing bleeding situations. Continuous oozing: Bleeding that will not stop with compression/simple packing. The solution for this bleeding is more time consuming than it is difficult. *Compared to SURGICEL Original Hemostat

Get to the source of the bleed Unique structure of the powder penetrates the surface of the blood to get to the source of bleeding 1,4 SURGICEL Powder is an aggregate of small oxidized regenerated cellulose (ORC) fiber fragments 5 ➊ SURGICEL Powder spreads across a large surface area 2,4 ➋ Blood saturates the material, providing a surface for platelet adhesion and aggregation, and initiating clot formation 1,4 ➌ Works fast to stop bleeding 1,4 ➍ Forms a durable clot that won t wash away or rebleed when irrigated 2 Indication: 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. 5

Built on a legacy of performance SURGICEL Powder is a unique addition to the SURGICEL Family of s Ordering Information Code Description Device Specifications Quantity (per box) 3013SP SURGICEL Powder 3.0 grams 5 units Further Information Please contact our customer support center at 877-ETHICON (384-4266) Situation Solution SURGICEL Part of the Hemostasis Optimization Program portfolio of adjunctive hemostats

SURGICEL Powder 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. SURGICEL Powder should not be used to control hemorrhage from large arteries. 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 s. 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 indications, contraindications, warnings, precautions, and adverse reactions, please reference full package insert. References: 1. Data on file. Ethicon, Inc. MacDonald MH. PSE Accession No. 15-0061. Pivotal Study Comparing Performance of SURGICEL Powder ic Powder to SURGICEL Original in a Swine Acute Liver Abrasion Model. 2015. 2. Data on file. Ethicon, Inc. MacDonald MH. PSE Accession No. 16-0006. Study Comparing Performance of SURGICEL Powder ic Powder to Marketed Competitive Powdered Topical Hemostats in a Swine Acute Liver Abrasion Model. 2016. 3. SURGICEL Endoscopic Applicator, Instructions for Use. Ethicon, Inc. 2015. 4. Data on file. Ethicon, Inc. Wang A. 2-59164. Surface Energy/Tension Analysis among ORC Aggregate, ORC Fine Fiber and Arista Project PIXIE. 5. SURGICEL Powder Absorbable Hemostat, Instructions for Use. Ethicon, Inc. 6. Spangler D, Rothenburger S, Nguyen K, Jampani H, Weiss S, Bhende S. In vitro antimicrobial activity of oxidized regenerated cellulose against antibiotic-resistant microorganisms. Surg Infect. 2003;4(3):255-262. 7. Dineen P. Antibacterial activity of oxidized regenerated cellulose. Surg Gynecol Obstet. 1976;142(4):481-486. 8. Data on file. Ethicon, Inc. Morris TD. Hill Top Biolabs Project No. 95-8673-21. Evaluation of Tissue Acceptability and Absorbability in a Rat Subcutaneous Implant Model of SURGICEL. 1995. 9. Data on file. Ethicon, Inc. Buehler EV. Hill Top Biolabs Project No. 92-8858-21 (A). Evaluation of Tissue Acceptability and Absorbability in a Rat Subcutaneous Implant Model of SURGICEL and SURGICEL NU-KNIT. 1993. 10. Data on file, Ethicon. Expression testing- ADAPTIV Document 100293850-1. 2017 Ethicon US, LLC. All rights reserved. 074300-170608