Competitive Efficiency of Local Application Hemostatic Agents in Experimental Parenchymatous and Arterial Bleeding Control

Abstract


Relevance Bleeding control in case of injury and surgery on parenchymatous organs and blood vessels is a serious challenge for surgery. Use of local application hemostatic agents is an innovative solution. Such agents are represented in Russia by foreign producers and Russian developments, but comparative evaluation of their efficiency is poorly known, that makes such research highly relevant.
The purpose of the study To compare efficiency of the Russian application hemostatic agent «Hemoflex® Pro» with foreign analogues on the models of parenchymatous and arterial bleeding.
Materials and methods Comparative efficiency analysis of hemostatic agent «Hemoflex® Pro» (LLC Inmed, RF) and agents «Surgicel® Nu-knit» (Johnson & Johnson, USA), «TachoComb®» (Nycomed Austria GmbH, Austria), «CeloxТМ Gauze Hemostat» (MedTrade Products Ltd, Great Britain) was carried out on the model of experimental parenchymatous and arterial bleeding of rats.
Results and their discussion Conducted comparative analysis of hemostatic agents in experiment on animals shows close time values of bleeding and blood loss of Russian and foreign application hemostatic agents by simulation of experimental parenchymatous bleeding. The agent «Hemoflex® Pro» showed better hemostatic effect by simulation of experimental arterial bleeding from a wound in aorta abdominal region. It also proved bactericidal action of «Hemoflex® Pro», its rapid bio degradation, lack of influence on formation of adhesive process in case of its use in abdominal region.
Conclusion Research marked similar hemostatic effect comparing action of «Hemoflex® Pro» with hemostatic agents «Surgicel® Nu-knit», «TachoComb®» and «CeloxТМ Gauze Hemostat». Moreover it registered bactericidal action of hemostatic agent «Hemoflex® Pro» against E.coli, S.aureus, S.pyogenes, C.albicans, Myc. smegmatis.

First Pavlov State Medical University of St. Petersburg, 6/8 L'va Tolstogo Str., Saint-Petersburg, 197089, Russian Federation

Author for correspondence.
Email: kuzet@mail.ru
First Pavlov State Medical University of St. Petersburg, Prof. of the Department of Hospital Surgery №2

First Pavlov State Medical University of St. Petersburg, 6/8 L'va Tolstogo Str., Saint-Petersburg, 197089, Russian Federation

Email: tvlasov@yandex.ru
First Pavlov State Medical University of St. Petersburg, Head of the Department of Pathological Physiology course with clinical pathophysiology

First Pavlov State Medical University of St. Petersburg, 6/8 L'va Tolstogo Str., Saint-Petersburg, 197089, Russian Federation

Email: admin@vestnik-surgery.com
Intern Department of Hospital Surgery №2, First Pavlov State Medical University of St. Petersburg

Inmed LLC, 2A Kirishskaia Str., Saint-Petersburg, 195299, Russian Federation

Email: evgenia.bragnikova@innmed.ru
PhD, Head of Laboratory of Polymer materials, Inmed LLC

Inmed LLC, 2A Kirishskaia Str., Saint-Petersburg, 195299, Russian Federation

Email: natalia.zabivalova@innmed.ru
PhD, Senior Researcher, Inmed LLC

  1. Boiarintsev V.V., Samoilov A.S., Iudin A.B., Kovalenko R.A. Techenie ranevogo processa pri ispol'zovanii mestnyh gemostaticheskih sredstv na osnove granulirovannogo ceolita. [The course of a wound process during use of local hemostatics based on granulated ceolite]. Infektsii v khirurgii, 2011; 9: 2: 43-50. - (in Russ.).
  2. Boiarintsev V.V., Iudin A.B., Nazarov V.B., Samoilov A.S., Fronchek E.V., Kovalenko R.A. Ocenka issledovaniya ehffektivnosti topicheskih gemostaticheskih preparatov (ehksperimental'noe issledovanie). [Nonclinical evaluation of efficiency of topical hemostatic agents (experimental research)]. Meditsina katastrof, 2010; 3: 23-25. - (in Russ.).
  3. Gorskii V.A., Shurkalin B.K., Leonenko I.V. Primenenie TakhoKomba v abdominal'noi khirurgii [Application TachoComb in abdominal surgery]. Moscow: Atmosfera. 2003. - (in Russ.).
  4. Gosudarstvennaia Farmakopeia SSSR [State Pharmacopoeia USSR. 11th ed. Issue 1]. Moscow: Meditsina, 1990. - (in Russ.).
  5. Navashin S.M., Fomina I.P.. Spravochnik po antibiotikam [Handbook of Antibiotics]. Moscow: Meditsina, 1982. - (in Russ.).
  6. Maistrenko A.N., Bezhin A.I., Lipatov V.A., Netiaga A.A., Ishunina T.A., Chizhikov G.M. Sravnitel'naya ocenka gemostaticheskoj aktivnosti novyh preparatov, primenennyh v ehksperimental'nyh travmah i operaciyah na pecheni i selezenke. [Comparative assessment of the hemostatic activity of new application drugs in experimental traumas and operations on the liver and spleen]. Kurskii nauchno-prakticheskii vestnik. Chelovek i zdorov'e, 2009; 2: 19-26. - (in Russ.).
  7. Sbornik rukovodiashchikh metodicheskikh materialov po toksikologo-gigienicheskim issledovaniiam polimernykh materialov i izdelii na ikh osnove meditsinskogo naznacheniia Minzdrava RF [Guidelines of Ministry of Healthcare of the Russian Federation on toxicological-hygienic research of polymer materials and polymer based medical devices. Issue 1.]. v. 1. M. 1987. - (in Russ.).
  8. Stepanov Iu.A., Karkishchenko N.N., Cherkasov M.F., Karkishchenko V.N., Kapanadze G.D., Boiarintsev V.V. et al. Izuchenie ehffektivnosti preparata «Gemostop» v ehksperimente na zhivotnyh. [To study the efficacy of the drug «Gemostop» in experiment on animals]. Biomeditsina, 2010; 5: 50-57. - (in Russ.).
  9. Chizhikov G.M. Sravnitel'nyj analiz gemostaticheskoj aktivnosti novyh lekarstvennyh sredstv dlya ostanovki kapillyarno-parenhimatoznogo krovotecheniya (ehksperiment v estestvennyh usloviyah) [Comparative analysis of hemostatic activity of new drugs to stop the capillary-parenchymal bleeding (experiment in vivo).] Vestnik eksperimental'noi klinicheskoi khirurgii, 2012; 5: 2: 390-392. - (in Russ.).
  10. Agger P., Langhoff J., Smerup M.H., Hasenkam J.M. Comparison between TachoComb and TachoSil for surgical hemostasis in arterial bleeding: an animal experimental study. J. Trauma, 2010; 68: 4: 838-842.
  11. Berrevoet F., B. de Hemptinne. Use of topical hemostatic agents during liver resection. Dig. Surg., 2007; 24: 4: 288-293.
  12. M. Bicer, A.S. Bayram, O. Gurbuz et al. Assessment of the efficacy of bio-absorbable oxidized regenerated cellulose for prevention of post-operative pericardial adhesion in the rabbit model. J. Int. Med. Res., 2008; 36: 6: 1311-1318.
  13. Brunkwall J., Ruemenapf G., Florek H.J., Lang W., Schmitz-Rixen T. A single arm, prospective study of an absorbable cyanoacrylate surgical sealant for use in vascular reconstructions as an adjunct to conventional techniques to achieve haemostasis. J. Cardiovasc. Surg. (Torino), 2007; 48: 4: 471-476.
  14. Beyea J.A., Rotenberg B.W. Comprasion of purified plant polysaccharide (HemoStase) versus gelatin-thrombin matrix (FloSeal) in controlling bleeding during sinus surgery: a randomized controlled trial. Ann. Otol. Rhinol. Laryngol., 2011; 120: 8: 495-498.
  15. Carraway J.W., Kent D., Yong K., Cole A., Friedman R., Ward K.R. Comparison of a new mineral based hemostatic agent to a commercially available granular zeolite agent for hemostasis in a swine model of lethal extremity arterial hemorrhage. Resuscitation, 2008; 78: 2: 230-235.
  16. Cole D.J., Connoly R.G., Chan M.W. et al. A pilot study evaluating the efficacy of a fully acetylated poly-N-acetyl glucosamine membrane formulation as a topical hemostatic agent. Surgery, 1999; 126: 3: 510-517.
  17. Dash M., Chiellini F., Ottenbrite R.M., Chiellini E.. Chitosan—a versatile semi-synthetic polymer in biomedical applications. Progress in Polymer Science, 2011; 36: 8: 981-1014.
  18. Ferretti L., Qiu X., Villalta J., Lin G. Efficacy of Bloodstop IX, Surgicel, and Gelfoam in rat models of active bleeding from partial nephrectomy and aortic needle injury. Urology, 2012; 80: 5: 1161-1166.
  19. Hickerson W.L., Nur I., Meidler R. A comparison of the mechanical, kinetic, and biochemical properties of fibrin clots formed with two different fibrin sealants. Blood Coagul. Fibrinolysis, 2011; 22: 1:19-23.
  20. Huri E., Akgul T., Ayyildiz A., Bagcioglu M., Germiyanoglu C. First clinical experience of Ankaferd Blood Stopper as a hemostatic agent in partial nephrectomy. Kaohsiung J. Med. Sci., 2010; 26: 9: 493-495.
  21. Kheirabadi B.S. Evaluation of topical hemostatic agents for combat wound treatment. US Army. Med. Dep. J., 2011; Apr-Jun: 25–37. Available at: http://www.cs.amedd.army.mil/dasqaDocuments.aspx?type=1.
  22. Koksal O., Ozdemir F., Cam Etoz B, Isbil N et. al.. Hemostatic effect of a chitosan linear polymer (Celox) in a severe femoral artery bleeding rat model under hypothermia or warfarin therapy. Ulus Travma Acil. Cerrahi Derg., 2011; 17: 3: 199-204.
  23. Lacaze L., Le Dem N., Bubenheim M. et al. Tensile strength of biological fibrin sealants: a comparative study. J. Surg. Res., 2012; 176: 2: 455-459.
  24. Millner R.W., Lockhart A.S., Marr R. Chitosan arrests bleeding in major hepatic injuries with clotting dysfunction: an in vivo experimental study in a model of hepatic injury in the presence of moderate systemic heparinisation. Ann. R. Coll. Surg. Engl., 2010; 92: 7: 559-561.
  25. Niekraszewicz A.. Chitosan Medical Dressings. Fibres & Textiles in Eastern Europe, 2005; 13: 6: 16-18.
  26. Ran Y., Hadad E., Daher S., Yegorov Y., Bartal C., Ash N. at al.. QuikClot Combat Gauze use for hemorrhage control in military trauma: January 2009 Israel Defense Force experience in the Gaza Strip--a preliminary report of 14 cases. Prehosp. Disaster. Med., 2010; 25: 6: 584-588.
  27. Warner R.L., McClintock S.D., Barron A.G., de la Iglesia F.A. Hemostatic properties of a venomic protein in rat organ trauma. Exp. Mol. Pathol., 2009; 87: 3: 204-211.
  28. Whang H.S., W. Kirsch, Zhu Y.H., Yang C.Z., Hudson S.M. Hemostatic agents derived from chitin and chitosan. J. Macromol. Sci., Part C: Polymer Reviews, 2005; 45: 4: 309-323.

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