ORIGINAL RESEARCH
Comparative analysis of efficacy of the new local hemostatic agents
1 Department of operative surgery and topographic anatomy, Kursk State Medical University, Kursk, Russia
2 Immanuel Kant Baltic Federal University, Kaliningrad, Russia
3 Russian Union of Chemical Complex Enterprises and Organizations, Moscow, Russia
Correspondence should be addressed: Dmitry A. Severinov
K.Marksa, 3, Kursk, 305041, Russia; ur.liam@39.vonireves.yirtimd
Author contributions: Lipatov VA — concept and design, article authoring, editing, approval of its final version; Lazarenko SV — experimental part, statistical processing, article editing, approval of its final version; Severinov DA — experimental part, article editing, approval of its final version; Denisov AA — experimental part, article authoring, literature data analysis; Chupakhin EG, Aniskina EN — experimental part, article authoring, literature analysis.
Compliance with ethical standards: the study was approved by the Ethics Committee (Minutes #3 of November 16, 2020), conducted in compliance with international and national standards for care and use of laboratory animals.
Various local hemostatics (based on collagen, gelatin, cellulose, etc.) are used to stop bleeding from parenchymal organs of the abdominal cavity. In the context of an acute in vivo experiment, this study aimed to comparatively assess the time and volume of bleeding from a trauma of abdominal cavity's parenchymal organs covered with a new collagen-based spongy hemostatics combined with Na-CMC. We used new multicomponent polymer sponge implants (MPSI) based on marine collagen and carboxymethyl cellulose sodium salt, Na-CMC; the components were mixed in the ratios of 15/85, 25/75, 50/50. Hemostatic activity of the samples was assessed by bleeding time and blood loss volume. For the experiments, rats underwent laparotomy and resection of the left lobe of liver (series 1) and lower pole of spleen (series 2). In both series of experiments, the controlled parameters (bleeding time and blood loss volume) were smallest in group 6, where the MPSI were 50/50 Na-CMC/collagen. The hypothesis of higher efficacy of composite local hemostatic agents (namely, made of Na-CMC and deep-sea squid collagen) in cases of trauma of the parenchymal organs was confirmed experimentally, and same experiment has also shown that collagen in the composition of MPSI boosts bleeding arrest (for liver injury, the smallest blood loss and hemorrhage control time was 41 s, for spleen injury — 57 s, respectively; p ≤ 0.05).
Keywords: bleeding, hemostasis, hemostatic sponges, polymers, in vitro experiment, collagen