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Studying the Efficacy of Local Hemostatic Agents In Vivo

https://doi.org/10.35401/2541-9897-2023-26-2-34-39

Abstract

Introduction: In modern clinical practice, there is no common and effective hemostatic agent for solid organs of the abdomen. Local agents such as hemostatic sponges, membranes, powders seem promising. The main advantages of hemostatic powders include relatively high efficacy, portability, versatility, as well as simplicity and low cost of manufacturing.

Objective: To study the hemostatic efficacy of hemostatic powders’ samples based on the sodium salt of carboxymethylcellulose (Na-CMC) in an acute in vivo experiment.

Materials and methods: The study was based at Kursk State Medical University. Fifty male Wistar rats (weighing 220-239 g) were selected as test animals. They were evenly divided into 5 groups: ARISTA AH, Cutanplast Powder, and Na-CMC hemostatic powders with 3 different dynamic viscosities: low (50-200 cP), medium (400-800 cP) and high (1500-3000 cP). Under general inhalation anesthesia, median laparotomy was performed in Wistar rats, the middle lobe of the liver was removed into the wound, and then marginal tangential resection was performed. We applied hemostatic powders of each group to the resulting wound, and then estimated the bleeding time and the volume of blood loss. We used the Mann-Whitney test (P ≤ .05) to assess the statistical significance of differences between the study groups.

Results: We recorded the minimum bleeding time and the smallest volume of blood loss for the samples based on the Na-CMC and found no statistically significant differences between the viscosities groups.

Conclusions: With Na-CMC hemostatic powder the bleeding time and the volume of blood loss were reduced by 3.6 and 2.2 times, respectively, comparing to the control group. These results were considered statistically significant (P ≤ .05).

About the Authors

V. A. Lipatov
Kursk State Medical University
Russian Federation

Viacheslav A. Lipatov, Dr. Sci. (Med.), Professor, Vice-Rector for Research and Innovative Development

Kursk



K. S. Tsilenko
Kursk State Medical University; European Medical Center
Russian Federation

Konstantin S. Tsilenko, Surgeon

Kursk

Moscow



A. A. Denisov
Kursk State Medical University
Russian Federation

Artyom A. Denisov, Assistant, Department of Operative Surgery and Topographic Anatomy

ulitsa Karla Marksa 3, Kursk, 305041, Russian Federation



P. D. Kondakova
Kursk State Medical University
Russian Federation

Polina D. Kondakova, 4th Year Student, Faculty of General Medicine

Kursk



References

1. Erdogan D, de Graaf W, van Gulik TM. Adhesive strength of fibrinogen-coated collagen patch or liquid fibrin sealant in an experimental liver resection model in pigs. Eur Surg Res. 2008;41(3):298–302. PMID: 18797168. https://doi.org/10.1159/000155879

2. Moldoveanu C, Geavlete B, Jecu M, et al. Bipolar plasma vaporization versus monopolar TUR and “cold-knife” TUI in secondary bladder neck sclerosis – an evidence based, retrospective critical comparison in a single center clinical setting. J Med Life. 2014;7(1):94–99. PMID: 24653766. PMCID: PMC3956105.

3. Maevskaya EN, Dresvyanina EN, Shabunin AS, et al. Preparation and study of hemostatic materials based on chitosan and chitin nanofibrils. Rossiiskie Nanotekhnologii. 2020;15(4):493–504. (In Russ.). https://doi.org/10.1134/s199272232004007x

4. Lipatov VA, Korovyakovskaya AV, Kuchina YaV, Denisov AA, Panov AA. Peculiarities of application of hemostaptic drugs during minimally invasive interventions. Innova. 2022;(3):18–23. (In Russ.).

5. Kabak VA, Belozerskaya GG, Momot AP, et al. Development and comparative evaluation of local hemostatic coatings based on natural polymers in an experiment on animals. Clinical Physiology of Circulation. 2019;16(1):67–75. (In Russ.). https://doi.org/10.24022/1814-6910-2019-16-1-67-75

6. Ivankova MN, Buzuk GN. Validation of the procedure for the

7. colorimetric digital image analysis determination of the composition of powders from medicinal vegetative raw materials. Vestnik Farmatsii. 2011;(1):21–25. (In Russ.).

8. Kinzerskiy AA, Dolgikh VT, Korzhuk MS, Kinzerskaya DA, Zaytseva VE. The Wistar rat line hemostatic system characteristics to be important for experimental surgery. Journal of Experimental and Clinical Surgery. 2018;11(2):126–133. (In Russ.). https://doi.org/10.18499/2070-478x-2018-11-2-126-133

9. Severtsev AN, Brekhov EI, Mironov NP. Use of topical pharmacological agents in achieving final hemostasis during liver resection. Khirurgiya. 2011;(1):86–90. (In Russ.).

10. Plisko EA, Danilov SR. Properties of chitin and its derivatives. In: Stepanenko BN, ed. Chemistry and Carbohydrate Metabolism. Nauka; 1965:141–145. (In Russ.).

11. Plavunov NF, Kadyshev VA, Goncharova NA, Bataev TA, Afanasov IM. Effectiveness of use of local hemostatic agents for external bleeding by visiting ambulance teams. Medical Alphabet. 2021;(42):25–29. (In Russ.). https://doi.org/10.33667/2078-5631-2021-42-25-29

12. Lipatov VA, Kryukov AA, Severinov DA, Saakyan AR. Ethical and legal aspects of in vivo experimental biomedical research of the conduct. Part II. IP Pavlov Russian Medical Biological Herald. 2019;27(2):245–257. (In Russ.). https://doi.org/10.23888/pavlovj2019272245-257

13. Lutsevich OE, Grin AA, Bichev AA, Shepelev VV. Features of the application of hemostatic material topical surgery. Moscow Surgical Journal. 2016;(3):12–20. (In Russ.).

14. Zhilyakova ET, Popov NN, Novikova MYu, Novikov OO, Fadeeva DA. Study of physic-chemical and technological characteristics of combined prolongator with Na-carboxymethylcellulose and polyvinyl alcohol in order to create prolonged dosage forms with liquid dispersion medium. Belgorod State University Scientific Bulletin. Medicine. Pharmacy. 2011;(22–2):69–79. (In Russ.).


Review

For citations:


Lipatov V.A., Tsilenko K.S., Denisov A.A., Kondakova P.D. Studying the Efficacy of Local Hemostatic Agents In Vivo. Innovative Medicine of Kuban. 2023;(2):34-39. (In Russ.) https://doi.org/10.35401/2541-9897-2023-26-2-34-39

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ISSN 2541-9897 (Online)