Comparison of the Effects of Hemostatic Agents in Experimental Splenic Injuries in Rat Models

Abstract

Background: One of the most common causes of trauma related deaths is hemorrhage due to splenic injury. The aim of the study was to compare the effects of hemostatic activities of Ankaferd blood stopper (ABS®), Oxidized Cellulose (Surgicel®) and FloSeal® in rats with experimental splenic injuries.
Materials and Methods: In this study we used twenty four female Wistar Albino rats. Grade 2 spleen laceration was performed on all rats. Rats were randomly divided into four groups each consist of 6 rats, as control, ABS, Surgicel and FloSeal. After performing grade 2 spleen laceration, sponge compression was applied to the control group and hemostatic agents were applied to the other groups. The amount and duration of bleeding and preoperative-postoperative hematocrit (Hct) levels were statistically compared between the groups.
Results: The amount and duration of bleeding was at least in the group using FloSeal, followed by ABS, Surgicel and control group, respectively. The amount of bleeding was; 0.27±0.04gr, 0.38±0.08gr, 0.63±0.09gr and 1.0±0.2gr respectively. The duration of bleeding was; 65.66±10.63s, 70.16±8.13s, 214.00±17.98s and 381.83±59.09s respectively. The amount and duration of bleeding was less in all groups using hemostatic agent compared to the control group (p<0.001). In the groups using FloSeal and ABS, the amount and duration of bleeding were significantly lower than Surgicel group (the amount of bleeding was p<0.001 and p=0.011, bleeding time p<0.001 and p<0.001, respectively). Although the amount and duration of bleeding was found at least in the FloSeal group but this difference was not statistically significant when compared with ABS group (bleeding amount p=0.476, duration p=0.842).
Conclusion: In our study, hemostatic agents that can be used in hemorrhage due to splenic laceration were found much more effective in stopping bleeding than the control group. In particularly, it was observed that FloSeal and ABS provide hemostasis and reduce the amount of bleeding more effectively than oxidized cellulose.

Keywords

• Ankaferd,FloSeal,Hemostasis,Oxidized cellulose

Deneysel Dalak Yaralanması Yapılan Ratlarda Hemostatik Ajanların Etkinliğinin Karşılaştırılması

Öz

Amaç: Travmaya bağlı ölümlerde en sık görülen nedenlerden birisi dalak yaralanmasına bağlı kanamalardır. Çalışmamızda deneysel dalak yaralanması yapılan ratlarda; Ankaferd blood stopper (ABS®), Oksidize Selüloz (Surgicel®) ve FloSeal®’ın hemostatik etkinliklerinin karşılaştırılması amaçlandı.
Materyal ve metod: 24 Wistar Albino Ratda grade 2 dalak laserasyonu oluşturuldu; Tüm ratlar; kontrol, ABS, Surgicel ve FloSeal kullanılan olmak üzere, her grupta rastgele 6 rat olacak şekilde 4 gruba ayrıldı. Dalakta grade 2 laserasyon yapıldıktan sonra kontrol grubunda spanç kompresyonu, diğer gruplarda hemostatik ajanlar kullanıldı. Gruplar arası; kanama miktarı, süresi ile preoperatif-postoperatif hematokrit (Hct) seviyeleri istatistiksel olarak karşılaştırıldı.
Bulgular: Kanama miktarı ve süresi en az FloSeal kullanılan grupta, ardından sırayla ABS, Surgicel ve kontrol grubunda idi. Kanama miktarları sırasıyla; 0.27±0.04gr, 0.38±0.08gr, 0.63±0.09gr ve 1.0±0.2gr iken kanama süreleri sırasıyla; 65.66±10.63s, 70.16±8.13s, 214.00±17.98s ve 381.83±59.09s idi. Hemostatik ajan kullanılan grupların tümünde kanama miktarı ve süresi kontrol grubuna göre daha az saptandı (p<0.001). FloSeal ve ABS kullanılan gruplarda ise kanama miktarı ve süresi Surgicel’e göre anlamlı olarak azdı (kanama miktarı sırasıyla p<0.001 ve p=0.011, kanama süresi p<0.001 ve p<0.001). Kanama miktarı ve süresi en az FloSeal grubunda saptanmasına rağmen ABS ile kıyaslandığında bu fark istatistiksel olarak anlamlı değildi (kanama miktarı p=0.476, süresi p=0.842)
Sonuç: Çalışmamızda, dalak laserasyonuna bağlı kanamalarda kullanılabilen hemostatik ürünlerin, kanamayı durdurmada kontrol grubuna göre çok daha etkin olduğu görüldü. Hemostatik ajanlardan FloSeal başta olmak üzere, ABS’nin de Surgicel’e göre daha etkin bir şekilde hemostazı sağladığı ve kanama miktarını azalttığı da gözlemlendi.

Anahtar Kelimeler

• Ankaferd,Dalak,FloSeal,Hemostaz,Oksidize selüloz

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