Hemostatic Effects Of Polysaccharide Hemostatic System On Artery Rupture And Hepatic Trauma In Rabbit

ObjectiveArtery Rupture has always been difficult to effectively first aid during the war because it often lead to hemorrhagic shock even death. It's an urgent problem in first aid that How to stop bleeding Fast and effectively and Reduce or avoid the adverse effects of limb blood circulation on the process of stop bleeding. There is a very common problem in Surgery wound bleeding or oozing because the traditional method operation for a long time to stop bleeding. Therefore, surgery requires a hemostatic faster, more conveniently and less complications.PerClotTM(Polysaccharide Hemostatic System PHS)is a new hemostatic materials developed for Surgery which contain the active ingredient called Absorbable Modified Polymer (AMP).when spread PerClotTM In the active bleeding site, Polysaccharide Hemostatic System absorb water molecules in the blood quickly but the red blood cells and plasma proteins and other ingredients because of the diameter control of PHS.So,the clotting time can be reduced. PerClotTM can be degraded within a few days in human body. Therefore the PerClotTM considered suitable for a variety of organizations' haemostasis and diffuse hemorrhage also the patients with anti-coagulation problem ,platelet dysfunction and other special patients.Aim of this topic is investigate hemostatic effects of polysaccharide hemostatic system on artery rupture and hepatic trauma in rabbit. Use Yunnan Baiyao which widely present in our military us positive control .by observing PerClotTM's hemostatic effect and the degradation also its impact on wound healing, we can offer theoretical and experimental basis supports to clinical application of PerClotTMMethodsMethod one: 12 New Zealand rabbits were randomly divided into 2 groups with 6 rabbits each group: control group and PerClotTM group. Dissect the rabbit and isolated the left femoral artery, and cut the femoral artery with ophthalmic scissors. Impose PerClotTM immediately on the bleeding sites of PerClotTM group, pressing with a cotton ball and timing.The control group only press with gauze. After 60s remove the cotton balls every 30s, observe Hemostatic effect in all groups. After 10m,Remove the cotton balls (or gauze) and standby. Observe the hemostatic effect on activities stability limb. Probe the wound for know the Homeostatic formation and test if the blood clots which blocking arteries was easy to break off that Lead to secondary hemorrhage. When material, blood dried on the cotton balls (or gauze) accurately weights them. Calculate the amount of bleeding.Method two: 24 New Zealand rabbits were randomly divided into 3 groups with 6 rabbits each group: control group, positive control group and PerClotTM group. Establish Hemorrhage model by make a standard wounds with 0.5 * 0.5cm area and 0.3cm deep in the lower part of rabbits' right liver. Impose PerClotTM 200mg in each bleeding wounds of PerClotTM group. Impose Yunnan Baiyao powder 200mg in each bleeding wounds of positive control group. On control group, each bleeding wound only Press by gauze. When Pressing 90s, 120s, 180s,Remove the cotton balls(or gauze) and observe Hemostatic effects of each one. After 10m,Remove the cotton balls (or gauze) and weight them. Calculate the amount of bleeding. Anesthesia and sacrifice 2 rabbits each group in 1d, 3d, 7d, 14d after operation. Coloring the wound of liver(Case of starch will turn blue-violet with iodine ) by iodine. After Observed the degradation of hemostatic agents and peritoneal adhesions, use 10% of the formaldehyde solution fixed the site tissue, embed by paraffin, cut to 50μm thick slices for pathological observation.ResultsResult one: Statistical analysis shows that : Both types of Hemostatic agents are able to play a full effect of hemostasis.In terms of the average amount of bleeding:PerClotTM group ((1.46±0.06) g on Average) less than control group((2.48±0.10)g on Average)(P<0.01). In terms of the average time of haemostasis:PerClotTM group ((100±30.1)s on Average) less than control group((200±36.33)s on Average)(P<0.01). At the time of observation on hemostasis stability we found : All experimental animal in activity does not rebleeding when activities stability limb. But when probing the wound found the combination of PerClotTM and artery rupture site not closely so that the easily stripped Blood clots lead to Rebleeding. Through trial and error, in the experiment we find: Extended time of debridement, removed the dressing with infiltration of saline solution and try to slow action to reduce the occurrence of bleeding risk.Result two: Three types of Hemostatic agents are 180 s played in full on hemostasis effect. The amount of bleeding in each group as follows: PerClotTM group (0.12±0.46)g, positive control group (0.48±0.14)g, control group (1.24±0.11)g.Statistical analysis shows that : In terms of the average amount of bleeding:PerClotTM group less than control group(P<0.01).PerClotTM sprinkled on the wound can be completely degraded within 3 ~ 7d.When laparotomy PerClotTM group, we can't or only see a slight abdominal adhesions in 3d,7d, 14d.the other side Yunnan Baiyao powder at the wound cannot be completely cleaned 3ds' later, when Laparotomy we found that the liver surface were associated with peritoneal adhesion which can separate by finger in this group. Can be observed under light microscope that: Positive control group, with marked hyperplasia of fibrous connective tissue around the wound, Most of the fibrin matrix is gradually replaced by vascular particles tissue which contains fibroblasts and macrophages. In PerClotTM group the PerClotTM has been sprinkled on the wound was degradated,Cells arranged in regular. These Results are in line with the general observation.ConclusionsPerClotTM can stop bleeding quickly and effectively in Artery Rupture ,save the haemostasis time(P<0.01),Reduce the amount of bleeding(P<0.01).it also Effective in reducing bleeding of wounds(P<0.01).Because it does not dissolve in water, characteristics of moderate degradation time, in short-term wounds will not rebleeding may caused by hemostatic material dissolved or degradation we can 3.consider that PerClotTM's Hemostatic effect is reliable. No or only a slight abdominal adhesions after Surgery shows that the material has good tissue compatibility. The clinical applications of PerClotTM will greatly increase the survival rate of patients with artery rupture, reduce intraoperative and postoperative bleeding in hepatobiliary surgery also the risk of liver rupture emergency surgery.