Comparison of hemostatic efficacy of topical Ankaferd Blood Stopper on heparinized and nonheparinized rats in bleeding related to liver injury.

Metin Ergin,Nazmi Özer

doi:10.1590/acb360106

Abstract

ABSTRACTPurpose:In this study, hemostatic efficacy of Ankaferd Blood Stopper (ABS), a new generation hemostatic agent, was compared in the presence of heparin effect.Methods:Forty-eight Wistar albino rats were divided into two main groups as heparinized and nonheparinized, and these two main groupswere divided into six subgroups as control, Surgicel and ABS (n = 8). Grade 2 liver injury was performed on rats as standard. All groups were compared in terms of weight, laceration surface area, prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR), bleeding time, bleeding amount, hemoglobin (Hb) levels, macroscopic and microscopic reactions to the agent used.Results:Whereas there was no statistically significant difference between weight, laceration surface area, PT, INR and preoperative Hb values in the heparinized and nonheparinized groups, postoperative Hb, bleeding time, bleeding amount and aPTT values were statistically different (p < 0.05). In the heparin-hemostat interaction, the ABS group had the lowest bleeding in the heparinized group in terms of the amount of bleeding compared to the control and Surgicel groups (F = 0.764; p = 0.047). In macroscopic and microscopic comparison, there was no difference between the groups in terms of cell necrosis andfresh bleeding (p > 0.05), it was found that the Surgicel group had statistical significantly higher reaction scores (p < 0.05) than the other groups in terms of other parameters.Conclusions:Ankaferd Blood Stopper can be safely and effectively used in surgical practice and in patients with additional diseases requiring heparinization, since it causes minimal reaction in the liver and decreases the amount of bleeding especially in the heparinized group.

Highlights

The liver is the largest solid organ in the human body and is the most frequently injured organ in abdominal trauma
This work aimed to compare Ankaferd Blood Stopper (ABS) efficacy with oxidized regenerated cellulose (Surgicel), which is a hemostatic agent, on heparinized and nonheparinized groups, since there is no previous study in the literature on intraabdominal solid organ bleeding who used anticoagulants with ABS before
Hemoglobin (Hb), prothrombin time (PT), activated partial thromboplastin time and international normalized ratio (INR) were measured from the blood taken from the tails of all rats 2 h after heparin administration

Summary

Introduction

The liver is the largest solid organ in the human body and is the most frequently injured organ in abdominal trauma. Except for gunshot and stab injuries, the majority of liver injuries occur as a result of blunt trauma[1]. Liver injuries resulting from blunt abdominal trauma are more complex than penetrating injuries and mortality rates are higher. Reported mortality rates according to the degree of injury are 7–13% for stage III, 30% for stage IV, and 66–82% for stage V and VI. In stage V and VI injuries, the vast majority of cases die before they have the opportunity to perform any intervention. Mortality rate in major liver surgery is 3–14%, and the most common reason for this is bleeding[1,2]

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