Journal of Experimental and Clinical SurgeryJournal of Experimental and Clinical Surgery2070-478X2409-143XVoronezh State Medical University132310.18499/2070-478X-2020-13-1-34-40UnknownSTUDY OF HISTOLOGICAL FEATURES OF LIVER REACTION USING NEW SAMPLES OF POLYMERIC HEMOSTATIC MATERIALS IN THE EXPERIMENT IN VIVOLipatovVyacheslav Aleksandrovichdrli@yandex.ruhttps://orcid.org/0000-0001-6121-7412LazarenkoSergej Viktorovichdok.lazarenko@yandex.ruhttps://orcid.org/0000-0002-7200-4508SeverinovDmitry Andreevichdmitriy.severinov.93@mail.ruhttps://orcid.org/0000-0003-4460-1353TarasovaAnastasia Valeryevnatarasova.anastaya9999@yandex.ruhttps://orcid.org/0000-0003-1715-229X25022020131344016042019Copyright © 2020, Lipatov V.A., Lazarenko S.V., Severinov D.A., Tarasova A.V.2020<p>Abdominal trauma in 26.7-40.8% of cases is accompanied by trauma of parenchymal organs. The condition of the patient with liver injury in 75% of cases is complicated by the development of hemorrhagic shock. In surgery, to achieve local hemostasis, the most promising method is the topical use of application hemostatic agents, while the composition of such funds determines the effectiveness of hemostasis.</p>
<p>The <strong>aim </strong>of the study is to assess the histological characteristics of the liver using new samples of polymeric hemostatic materials in the experiment in vivo.</p>
<p><strong>Materials and methods.</strong> As research material was used hemostatic sponge based on natrocarbonatite (Na-CMC) (developed jointly with Linteks, Russia. Saint-Petersburg.) In the experimental groups of laboratory animals under general anesthesia produced a median laparotomy and simulated planar surface injury to the liver. Parenchymal bleeding was stopped by applying application hemostatic materials. An autopsy of the injured area of the liver was performed together with an implanted hemostatic agent. The thickness of the capsule, the size of the Central veins of the liver, the number of dual-core hepatocytes, the size of hepatocytes and their nuclei were measured.</p>
<p><strong>Results</strong>. The indicator of the area of hepatocytes of groups No. 4 and No. 5 are as close as possible to group No. 1 indicators. Similar to the area of hepatocytes, difference of the area of their kernels in groups No. 6, No. 7 are statistically not significant in comparison with group No. 1. In groups No. 6 and No. 5 the area of kernels is authentically increased, but does not reach values of control group. The greatest statistically significant increase in thickness of the capsule in comparison with group No. 1, group No. 2 and No. 3 was observed in group No. 4. The area of the central vein is authentically increased in comparison with control group in groups No. 2, No. 3 and No. 6. The number of two-nuclear hepatocytes in comparison with norm, group No. 4 and group No. 1 is reliable above in groups No. 6 and No. 7.</p>
<p><strong>Conclusion</strong>. Histologic reorganizations, changes of morphological structure in places of a trauma and implantation of the tested samples are less expressed when using haemo static implants of experimental groups No. 3-№6 (styptic local means on the basis of Na-KMTs with addition of aminocaproic, acetilsalicylic and aminoacetic acids).</p>Carboxymethylcellulose, application materials, hemostatic activity, implants, polymer sponges, liver, bleeding.Карбоксиметилцеллюлоза, аппликационные материалы, гемостатическая активность, импланты, полимерные губки, печень, кровотечение.[1. Bordakov VN., Doronin MV., Savitsky DS., Vasilevsky MP. Comparative characteristic of methods of a local hemostasis at bleeding from a liver in an experiment. Transfusiology. 2010; 12 (2-3):18. (In Russ).][2. Lipatov VA., Lazarenko SV., Sotnikov KA., Severinov DA., Ershov MP. To the issue of methodology of comparative study of the degree of hemostatic activity of topical hemostatic agents. Novosti khirurgii. 2018;1(26):81-95. (In Russ). doi: 10.18484/2305-0047.2018.1.81][3. Gain YM., Alexandrova OS., Gapanovich VN. Modern methods of a local hemostasis at damage of parenchymatous bodies of a stomach. Novosti khirurgii. 2009; 4:160-171. (In Russ).][4. Romanova LP., Malyshev II. A role of binuclear hepatocytes in regeneration of a liver after a mechanical trauma in early ontogenesis at rats. The Bulletin of the Chuvash university. 2011; 3: 398-402. (In Russ).][5. Romanova LP., Malyshev II. Influence Influence of biologically active agents on biological activity of hepatocytes of fruits and newborns is ratted after a mechanical injury of a liver. The Kazan medical magazine. 2011; 92(6): 904-906. (In Russ).][6. Charyshkin AL., Gafiullov MR, Dyomin VP. Assessment of results of sewing up of wounds of a liver and spleen at the closed injuries of abdominal organs. The Bulletin of experimental and clinical surgery. 2012; 5(3): 593-595. (In Russ).][7. Chizhikov GM., Bezhin AI., Ivanov AV., Maystrenko AN., Lipatov VA., Netyaga AA., et al. Experimental studying of new means of a local hemostasis of surgery of a liver and spleen. Person and his health. 2011; 1:19-25. (In Russ).][8. Biçer M., Bayram AS., Gürbüz O. 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; 36:1311-1318. doi: 10.1177/147323000803600619.][9. Sampanis D., Siori M. Surgical use of fibrin glue-coated collagen patch for non-hemostatic indications. European surgery. 2016; 48(5): 262-268. doi: 10.1007/s10353-016-0436-y.][10. Grimm C., Polterauer S., Helmy S., et al. 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; 14:635-642. doi: 10.1186/1471-2407-14-635.][11. Mita K., Ito H., Murabayashi R., Asakawa H., Nabetani M., Kamasako A., et al. 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; 6:601-605. doi:10.1177/1553350615580649][12. Choi SM., Ryu HA., Lee KM., Kim HK., Park IK., Cho WJ., et al. Development of stabilized growth factor-loaded hyaluronate–collagen dressing (HCD) matrix for impaired wound healing. Biomaterials Research. 2016; 9:532-540. doi: 10.1186/s40824-016-0056-4][13. Petersen M., Steinert R., Jannasch O., Venerito M., Meissner C., Kropf S., et al. Sealing of the hepatic resection area using hemostatic devices does not improve results of adequate surgery. Zeitschrift fur Gastroenterologie. 2016;7: 634-641. doi: 10.1055/s-0042-100284]