Journal of Experimental and Clinical SurgeryJournal of Experimental and Clinical Surgery2070-478X2409-143XVoronezh State Medical University130010.18499/2070-478X-2019-12-4-261-265UnknownStudy of the Special Features of the Surface of Application Hemostatic ImplantsLipatovVyacheslav Aleksandrovich<p>M.D., Professor, Department of operative surgery and topographic anatomy</p>drli@yandex.ruhttps://orcid.org/0000-0001-6121-7412LazarenkoSergey Viktorovich<p>Ph.D., assistant of the Department of oncology</p>dok.lazarenko@yandex.ruhttps://orcid.org/0000-0002-7200-4508SeverinovDmitriy Andreevich<p>assistant of the Department of anatomy</p>dmitriy.severinov.93@mail.ruhttps://orcid.org/0000-0003-4460-1353UshanovAlexander Aleksandrovich<p>student </p>sansany226@rambler.ruhttps://orcid.org/0000-0003-0876-0656Kursk state medical University2712201912426126527022019Copyright © 2019, Lipatov V.A., Lazarenko S.V., Severinov D.A., Ushanov A.A.2019<p><strong><em>Background:</em></strong> One of the important unsolved problems of hepatobiliary surgery is to stop the bleeding of the parenchymal organ. The most promising means of local hemostasis are spongy implants made of various materials, the study of which is one of the leading directions in modern surgery. Nevertheless, despite the relevance of the research, there is no uniform classification of the structural features of such hemostatics.<br /> <strong><em>Aims:</em></strong> to study the features of the surface of the application of hemostatic implants based on collagen and Carboxymethylcellulose Sodium.<br /> <strong><em>Materials and methods:</em></strong> the authors performed light microscopy of the samples, photographing and subsequent processing of the photographs obtained using the trial version of the graphic editor Adobe Photoshop CS6 (Adobe Systems, San Jose, United States of America) to obtain black and white images by enhancing the contrast (+400 ), which excluded the possibility of false color definition. The black and white pixels were counted using the Altami Studio 3.4 program (Altami LLC, St. Petersburg, Russian Federation). Then, the real pixel size was converted into percentages using the trial version of Statistica 10.0 (Dell Software Company, Round Rock, United States of America). After that, the ratio of low areas of the implant (black pixels) to high (white pixels) was determined.</p>
<p><br /> <strong><em>Results:</em></strong> According to the data obtained, a classification was developed for the heterogeneity of the surface of the relief of hemostatic implants, according to which all of them can be divided into three groups: with weak, moderate and strong severity of the heterogeneity of the surface relief.<br /> <strong><em>Conclusions: </em></strong>when correlating the obtained results and selected groups, it was found out that the hemostatic sponge Tachocomb (Takeda Pharmaceuticals LLC, Linz, Austria) has a slightly pronounced heterogeneity of the surface relief, and the hemostatic collagen sponge (OJSC Luga Belkozin, Luga, Russian Federation) and a Carboxymethylcellulose based hemostatic sponge (developed in cooperation with Linteks LLC, St. Petersburg, Russian Federation) - moderately pronounced surface heterogeneity.</p>Experimental Implants, Carboxymethylcellulose Sodium, hemostasis, microscopyКровоостанавливающие импланты, натрий-карбоксиметилцеллюлоза, остановка кровотечения, световая микроскопия, микроскопическая структура, гемостатическая губка[1. Petersen M., Steinert R., Jannasch O., Venerito M., Meissner C., Kropf S., Albrecht R., Lippert H., Meyer F. Sealing of the hepatic resection area using hemostatic devices does not improve results of adequate surgery // Zeitschrift fur Gastroenterologie. – 2016. – №7 – C.634-641.][2. Choi S.M., Ryu H.A., Lee K.M., Kim H.K., Park I.K., Cho W.J., Shin H.C., Choi W.J., Lee J.W. Development of Stabilized Growth Factor-Loaded Hyaluronate– Collagen Dressing (HCD) matrix for impaired wound healing // Biomaterials Research. – 2016. – №9. – C. 532-540.][3. Чернявский А.М., Григорьев И.А., Ткачева Н.И., Морозов С.В., Таркова А.Р. Контроль локального гемостаза с помощью препаратов окисленной целлюлозы // Хирургия. Журнал им. Н.И. Пирогова. – 2014. – №8. – C. 71-75.][4. В.А. Липатов, С.В. Лазаренко, К.А. Сотников, Д.А. Северинов, М.П. Ершов. К вопросу о методологии сравнительного изучения степени гемостатической активности аппликационных кровоостанавливающих средств // Новости хирургии. – 2018. – №1 (26). – С. 81-95.][5. Давыденко В.В., Власов Т.Д., Доброскок И.Н., Бражникова Е.Н., Забивалова Н.М. Сравнительная эффективность аппликационных гемостатических средств местного действия при остановке экспериментального паренхиматозного и артериального кровотечения // Вестник экспериментальной и клинической хирургии. – 2015. – №2. – С. 186-194.][6. Mita K., Ito H., Murabayashi R., Asakawa H., Nabetani M., Kamasako A., Koizumi K., Hayashi T. Use of a Fibrinogen/Thrombin-Based Collagen Fleece (TachoComb, TachoSil) With a Stapled Closure to Prevent Pancreatic Fistula Formation Following Distal Pancreatectomy // Surgical Innovation. – 2015. – №6. – С. 601-605.][7. Инархов М. А., Липатов В.А., Затолокина М.А., Ярмамедов Д.М., Лазаренко С.В. К вопросу изучения физико-механических свойств и особенностей новых деградируемых полимерных пленочных имплантов для операций на органах брюшной полости // Курский научно-практический вестник «Человек и его здоровье». – 2016. – № 3. – С. 67-73.][8. Маркин В.И., Базарнова Н.Г., Галочкин А.И. О взаимодействии лигноуглеводных материалов с монохлоруксусной кислотой // Химия растительного сырья. – 1997. – № 1. – С. 26-28.][9. Липатов В.А., Григорьев Н.Н., Лазаренко С.В., Северинов Д.А., Сотников К.А., Ушанов А.А. Установление структурных особенностей ковоостанавливающих имплантов на основе натрий-карбоксиметилцеллюлозы с помощью световой микроскопии // Современные проблемы науки и образования. – 2018. – № 6. URL: http://www.science-education.ru/article/view?id=28315 (дата обращения: 17.01.2019).][10. Grimm C., Polterauer S., Helmy S., Cibula D., Zikan M., Reinthaller A., Tempfer C. A collagen-fibrin patch (Tachosil®) for the prevention of symptomatic lymphoceles after pelvic lymphadenectomy in women with gynecologic malignancies: a randomized clinical trial // BMC Cancer. – 2014. – №14. – С. 635-642.]