Abstract
Purpose of the study: to conduct a morphological study of experimental material to assess the features of wound healing in the anal sphincter area when using the domestic drug “Heprocel” as a hemostatic agent. Material and methods. The study was carried out in the Department of experimental surgery and the department of pathological anatomy of the Republican Specialized Scientific and Practical Medical Center for Surgery named after Academician V. Vakhidov. The state of experimental models of wounds with the application of a hemostatic agent in the form of a gel was studied. The experiments were carried out on 72 white male rats weighing 210-250 g. Two series of 36 animals each were produced. All animals were divided into groups: norm - experiment in the absence of drug hypocoagulation; control - an experiment with intravenous heparin to achieve drug hypocoagulation; experience - an experiment with intravenous administration of heparin to achieve drug hypocoagulation using an application on a model of a skin wound and a dissected anal sphincter of the hemostatic agent "Heprocel". Results. Morphological differences in the process of wound healing were most pronounced after 3 days of the study. In the control group of animals with hemostasis using an electrocoagulator, necrotic and exudative processes of inflammation in the stratified squamous epithelium and mucous membrane of the glands in the anal region were evident. In the experimental group, on the 3-5th day of the experiment, the proliferative process of inflammation predominated morphologically. A special feature is that the hemostatic gel is absorbed into the wound, forming a thin uniform layer. On the 10th day of the experiment, the above difference became more obvious. In the control group, chaotic squamous epithelial cells and fibroblasts were formed. The fibrin-necrotic layer is preserved. Focal infiltration of macrophages-lymphocytes was observed. In the experimental group, the intestinal layers began to change. In the area of the surgical incision, the hemostatic layer is preserved; in this area, the growth of thin fibrous connective tissue is observed. Differentiation and transformation of cells led to the regeneration of the epithelial layer and parakeratosis of the flat cell. Signs of complete remodeling were evident over a long period of time, such as 14 days. Conclusion. The use of a hemostatic agent in the form of a gel provides not only an increase in the processes of local hemostasis, but a decrease in the activity of inflammatory reactions and infection, as well as the risk of developing post-traumatic cicatricial deformity of the anus.
Highlights
Today, hemorrhoids are characterized by their relevance among coloproctological diseases
All animals were divided into groups: norm - experiment in the absence of drug hypocoagulation; control - an experiment with intravenous heparin to achieve drug hypocoagulation; experience - an experiment with intravenous administration of heparin to achieve drug hypocoagulation using an application on a model of a skin wound and a dissected anal sphincter of the hemostatic agent "Heprocel"
The use of the hemostatic coating "Heprocel" allows you to achieve a proliferative process of inflammation in the wound, while hemostasis by electrocoagulation promoted the development of necrotic-exudative inflammation processes
Summary
Hemorrhoids are characterized by their relevance among coloproctological diseases. The existing modified methods prototypes do not provide all the required conditions for the surgical treatment of chronic hemorrhoids III-IV stages against the background of drug hypocoagulation, and are associated with the development of postoperative complications such as bleeding, narrowing of the anal canal and eruption of sutures after stool with prolonged wound healing, since at all In the above operations, a closed or open wound surface remains in the rectum [7, 8]. The most pressing issues of colorectal surgery are the development of drugs and technologies aimed at enhancing the processes of local hemostasis, reducing the activity of inflammatory reactions and infection, reducing the risk of recurrent bleeding, as well as the risk of developing post-traumatic cicatricle deformity of the anus [9, 10]
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