Histological picture of changes in the area of placement of samples of combined sponge hemostatic agents

Objective - to study the tissue reaction of samples of combined sponge hemostatic agents during subcutaneous implantation in vivo.

Materials and methods. Seven study groups were formed. Under general inhalation anesthesia, male Wistar rats were subjected to a 7-cm-long cut through the skin and subcutaneous fat layers along the paravertebral line on the right. Two pockets were bluntly made in the subcutaneous tissue between the muscle and skin layers on both sides of the cut, 3.5 cm deep, along the entire length of the cut. The studied samples measuring 2 x 2 cm were placed in each pocket. The surgical wound was tightly sutured, capturing the muscle layer in order to isolate the pockets containing the experimental samples. The animals were excised on the 7th, 14th, and 28th days after placement of the HPCS in the subcutaneous fat. An autopsy was then performed, followed by morphological examination. For statistical processing of the results, the median Me [25; 75] was determined. To check the statistical significance, the Kruskal-Wallis criterion was used. The level of p≤0.05 was considered acceptable for experimental biomedical studies.

Results. In experimental group #1 (Na-CMC+15% collagen), an almost uniform distribution of the fibrous layer of the capsule was noted at all observation periods, and in experimental group #2 (Na-CMC+25% collagen), the severity of the fibrous layer of the capsule decreased by the 28th day of the experiment. In experimental group #3 (Na-CMC + 50% collagen), an increase in the thickness of the fibrous layer of the capsule around the studied samples was noted.

Conclusion. Analysis of the obtained data in three series of experiments with subcutaneous placement of a combined sponge consisting of collagen and Na-CMC of increasing concentration showed that an increase in the proportion of collagen relative to the content of CMC in the HPCS leads to an increase in the inflammatory reaction in the area of its placement, which is confirmed by the statistical significance of the differences (p<0.05).

1. Vorontsov A.K., Parkhisenko Yu.A., Cherednikov E.F., Klimashevich A.V., Barannikov S.V., Chernykh A.V., Bezaltynnykh A.A. Experimental substantiation of the application of a new method of surgical hemostasis of extensive traumatic liver injuries. Volgogradskiy nauchno-meditsinskiy zhurnal. 2023;20(2):45-50 (in Russ.). EDN: HSJMKR.

2. Fontes C.E.R., Mardegam M.J., Prado-Filho O.R., Ferreira M.V.Comparative analysis of surgical hemostatic sponges in liver injury: study in rats. Arquivos Brasileiros de Cirurgia Digestiva. 2018;31(1):Art.e1342. DOI: 10.1590/0102-672020180001e1342.

3. Rot’kin E.A., Agalaryan A.Kh., Agadzhanyan V.V. Features of diagnostics and treatment of injuriesto parenchymatous abdominal organs in polytrauma. Politravma. 2023;(1):29-33 (in Russ.). EDN: KJVXLO.

4. Svarich V.G., Svarich V.A. Hemostasis for central rupture of liver in a child. Khirurgiya. Zhurnal im. N. I. Pirogova. 2023;(2):115-119 (in Russ.). DOI: 10.17116/hirurgia2023021115. EDN: EIEHXY.

5. García I.C., Villalba J.S., Iovino D. Liver Trauma: Until When We Have to Delay Surgery? A Review. Life (Basel). 2022;12(5):Art.694. DOI: 10.3390/life12050694.

6. Simpson A., Shukla A., Brown A.C. Biomaterials for Hemostasis. Annual review of biomedical engineering. 2022;24:111-135. DOI: 10.1146/annurev-bioeng-012521-101942.

7. Gorskiy V.A., Agapov M.A., Protasov A.V., Iskhakov R.R. The use of fibrin-collagen substance in case of spleen injuries. Khirurgiya. Zhurnal im. N.I. Pirogova. 2013;(12):73-77 (in Russ.). EDN: PZLJDD.

8. Vanina A.S., Grekhneva E.V., Kudryavtseva T.N., Lipatov V.A., Denisov A.A. Creation of hemostatic polymer materials and evaluation of their sorption properties. Problems of science. Chemistry, Chemical technology and Ecology : Proceedings of the All-Russian Scientific and Technical Conference, Novomoskovsk, October 31-November 02, 2022. Tula: Akvarius. 2022:350-354. (in Russ.)

9. Kabak V.A., Belozerskaya G.G., Momot A.P., Nevedrova O.E., Logvinova Yu.S., Kalelova A.V., Akopyan L.V. Evaluation of the effectiveness of the hemostatic action of thrombin in experiments "in vivo" and "in vitro". Byulleten’ meditsinskoy nauki. 2023;3(31):36-45 (in Russ.). DOI 10.31684/25418475-2023-3-36. EDN: HEXSNP.

10. Pekrul I., Schachtner T., Zwißler B., Möhnle P. Tranexamic acid for bleeding prophylaxis in orthopedic surgery and trauma-standard or customized therapy? Der Anaesthesist. 2021;70(6):515-521. DOI 10.1007/s00101-021-00928-5.

11. Belozerskaya G.G., Momot A.P., Pykhteyeva M.V., Belozerov D.E., Bychichko D.Yu., Nevedrova O.E., Kabak V.A., Malykhina L.S., et al.Comparative evaluation of the hemostatic properties of local coatings based on kappa-carrageenan in vitro. Klinicheskaya fiziologiya krovoobrashcheniya. 2019;16(2):148-157 (in Russ.). DOI: 10.24022/1814-6910-2019-16-2-148-157. EDN: ZUQAIH.

12. Davydenko V.V., Vlasov T.D., Dobroskok I.N., Brazhnikova E.N., Zabivalova N.M.Comparative effectiveness of topical hemostatic agents in stopping experimental parenchymal and arterial bleeding. Vestnik eksperimental’noy i klinicheskoy khirurgii. 2015;8(2):186-194. (in Russ.). EDN: ULZGUR.

13. Lipatov V.A., Bordunova M.A., Panov A.A., Denisov A.A. On the issue of classification of local hemostatic agents. Innova. 2022;4(29):38-41 (in Russ.). DOI: 10.21626/innova/2022.4/08. EDN: NVRDZI.

14. Sun W., Gregory D.A., Tomeh M.A., Zhao X. Silk fibroin as a functional biomaterial for tissue engineering.International journal of molecular sciences. 2021;22(3):Art.1499. DOI 10.3390/ijms22031499.

15. Soldatova D.S., Bezhin A.I., Ishunina T.A. Effectiveness of a combined agent with hemostatic and anti-adhesive activity in liver surgery in an experiment. Annaly khirurgicheskoy gepatologii. 2020;25(4):126-135 (in Russ.). DOI 10.16931/1995-5464.20204126-135. EDN: MAUKOP

16. Khat’kov I.E., Izrailov R.E., Pankratov A.A., Zhdanov A.V. Opportunities of endovideosurgical interventions in thoracic and abdominal trauma. Khirurgiya. Zhurnal im. N.I. Pirogova. 2016;(1):15-19. (in Russ.). EDN: VOATPP.

17. Lipatov V.A., Severinov D.A., Kryukov A.A., Saakyan A.R. Ethical and legal aspects of in vivo experimental biomedical research of the conduct. Part II. Rossiyskiy mediko-biologicheskiy vestnik imeni akademika I. P. Pavlova. 2019;27(2):245-257 (in Russ.). DOI: 10.23888/PAVLOVJ2019272245-257. EDN: GIEJQL