Abstract
Aim: comparative assessment of the effectiveness of hemostatic materials in an acute experiment in vivo . Materials and methods. We studied samples of hemostatic materials TachoComb (No. 1), Gelita-Spon Standard (No. 2), Surgicel Fibrillar (No. 3), samples of hemostatic sponges developed jointly with LLC ”Lintex“ (St. Petersburg, Russia) based on sodium carboxymethyl cellulose ( Na-CMC): Na-CMC + Tranexamic acid, pressed (No. 4), Na-CMC + Tranexamic acid, uncompressed (No. 5), Na-CMC pressed (No. 6), Na-CMC uncompressed (No. 7). Rats under general anaesthesia were given a middle laparotomy, and the partial liver resection of the left liver lobe was simulated. The bleeding was stopped by application of test materials. Blood loss volume (blood volume absorbed by one sample), bleeding time were evaluated. We applied nonparametric criterion of Mann-Whitney ( p ≤ 0.05) to determination of reliability of differences. Results . The lowest values of the index ”Bleeding time“ are observed in experimental groups No. 4-No. 7. Among the samples of these groups there are the following statistically significant differences: the values of the samples of group No. 4 are 1.5 times higher than that of sample No. 5; 2.68 times – group No. 6; 2.41 times – groups No. 7. The values of samples of group No. 7 are 1.74 times less than samples of group No. 5 and 4 seconds more than in group No. 6. When comparing blood loss volume in investigated groups, fewer statistically significant differences are observed. But the values of the samples of group No. 2 significantly exceed the values of all experimental groups. Conclusion . The use of a local hemostatic agent based on Na-CMC (with and without the addition of tranexamic acid) in stopping bleeding after the partial liver resection in laboratory animals (rats) is no less than clinically introduced applicational hemostatic agents such as TachoComb, Gelita-Spon Standard and Surgicel Fibrillar.
Highlights
ФГБОУ ВО “Курский государственный медицинский университет” Минздрава России; 305041, г
We studied samples of hemostatic materials TachoComb (No 1), Gelita-Spon Standard (No 2), Surgicel Fibrillar (No 3), samples of hemostatic sponges developed jointly with LLC ”Lintex“
The bleeding was stopped by application of test materials
Summary
Примечание: здесь и далее КМЦ – карбоксиметилцеллюлоза; ТК – транексамовая кислота; П – прессованный; НП – непрессованный. North Rd (Nanshan Dist., Shenzhen, Guangdong Province, Китай). В стерильных условиях операционного блока лаборатории экспериментальной хирургии и онкологии НИИ экспериментальной медицины ФГБОУ ВО КГМУ Минздрава России после стандартной трехкратной обработки операционного поля крысам-самцам линии Вистар массой 200–250 г выполняли срединную лапаротомию. В рану выводили левую долю печени и выполняли ее краевую резекцию – отсекали участок 10 × 5 × 5 мм (рисунок). На кровоточащую область разреза накладывали исследуемое гемостатическое средство соответствующих ране размеров (1,0 × 1,0 см) с известной массой. Оценивали объем кровопотери (объем крови, впитанный одним образцом), время кровотечения. Объем кровопотери (V) определяли гравиметрическим методом Е.М. Этапы операции: а – в лапаротомную рану выведена доля печени; б – момент нанесения травмы.
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