Evaluation of Effectiveness of New Samples of Chitosan-Based Local Hemostatic Agents After Liver Resection in Experiment

INTRODUCTION: Chitosan-based local hemostatic agents are most promising in terms of effective stoppage of bleeding, additional properties (for example, antibacterial effect) and stimulation of regeneration. New forms of them are being developed for different types of organ damage.

AIM: To evaluate the hemostatic effect of samples of new chitosan-based local hemostatic agents on a liver resection model.

MATERIALS AND METHODS: An in vivo experiment was performed on 60 white male rats of Wistar line of 200 g–250 g mass. The animals were divided to 4 study groups of 15 animals, respectively, depending on the kind of hemostatic agent and additional introduction of an anticoagulant that enhanced bleeding. As study materials, hemostatic collagen sponge (control groups No. 1.1 and 1.2) and also samples of new chitosan-based hemostatic agents — Сhitocol-Hemo® (Evers, Russia) were used. The rats under general anesthesia underwent midline laparotomy followed by laparopexy by dissecting the falciform ligament of the liver and placement of a gauze turunda between the diaphragm and the left liver lobule with displacement of the latter into the wound. After this, a sterile gauze turunda of the known mass was placed under the left lateral lobe of the liver, and resection of this lobe was performed at 10 mm distance from the edge. The bleeding was stopped by application of the tested materials. The mass of blood loss (gravimetric parameters) and the time of bleeding were evaluated. The reliability of the differences was determined using nonparametric Mann-Whitney test.

RESULTS: In animals that were not administered the anticoagulant before modeling of the liver trauma, statistically significant differences were found only in such parameters as increase in the sample mass after impregnation with blood, in percent. Here, the value of this parameter in the group with use of hemostatic collagen sponge (2262.9) was three times that in the group using hemostatic Сhitocol-Hemo® (722.7) p = 0.000003. The differences between the groups with heparin therapy were of similar character (p = 000003).

CONCLUSION: The hemostatic effect of the sample of Сhitocol-Hemo® hemostatic agent was confirmed in an acute experiment on a model of liver injury in rats on the basis of measurement of the mass of blood lost, of blood absorbed by the sample, and also of bleeding time. This hemostatic effect is probably provided due to positive physicochemical characteristics (porous structure, stroma/pores ratio and composition of the agent.