Effect Of Shuruiji On Hemostasis Of Traumatic Liver And Postoperative Peritoneal Adhesions In Dogs

As the increasing number of companion animals such as dogs and cats, the diagnosis and treatment technology is developing rapidly, especially in surgery. During surgical procedure, some problems such as bleeding, prevent adhesion has been plagued with researchers. In particular the large area of diffuse infiltration bleeding, which is hard to stop, even leading to wound fibrin deposition which will cause abdominal adhesions. Today’s favored hemostatic methods, such as compression, ligation and electrocoagulation are difficult to achieve the desired effect. All hemostatic materials have their own shortcomings or limitations, although a lot of materials were used in clinical practices. Furthermore, some materials often leads to adhesions or postoperative complications thus causing difficulties for reoperation. Therefore, it is necessary to develop a more effective and safe hemostatic materials. In this study, 30 healthy dogs were recruited for trials. 18 dogs were randomly divided into three(n=6) groups. According to the American trauma surgery association(AAST) classification standard[1], a diameter 2cm × 0.5cm depth trauma were made in the left lateral lobe of the liver in all groups to establish grade IV liver trauma model. The experimental group were treated with the biological fluid film to stop the bleeding, but the control group using Surgicel(hemostatic gauze) and blank control group only using gauze pressing to stop the bleeding. During the surgery, hemostasis time were recorded. On 3 or 5 days after surgery, 3 dogs in each group was select randomly, opening the abdominal cavity, to observe the wound recovery and degradation of the hemostatic material. In addition, wound tissue samples were collected for pathological analysis and the hydroxyproline concentration were detected. The remain 12 dogs were randomly divided into three groups(n=4) and intestinal adhesion model were established. On the seventh day after operation, abdominal cavity was opened again to assess the adhesion degree according to Jianmin Hu grading method[2]. Wound tissue samples were collected for pathological analysis and the hydroxyproline concentration were detected as well.The liver injury bleeding model showed that the bleeding time in Shuruiji group and Surgicel group were obviously less(p<0.05, p<0.05) than the control group, but there was no differences between Shuruiji group and Surgicel group. We found the wound were significantly difference among the three groups at 3 th day after surgery, in detail, the control group was out of flatness with a blood clot; in Surgicel group the liver wound was adherent with abdominal wall; but the wound of Shuruiji group was no bleeding and no adhesions. On 7 th day, the liver capsule was rupture with an uneven surface in control group. In the Surgicel group the wound was adherent to the abdominal wall with some Surgicel absorbed and it was hardly to separated. However, in Shuruiji group, the wound was smooth and no adhesions. The results of blood routine and biochemical test showed no differences among all groups. The histopathologic analysis showed that the bleeding in the control group was significantly more than the Shuruiji group at 3th day after surgery. On 7th day, the control group and the S urgicel group were formed with severe fibrosis proliferation and had large number of inflammatory cell infiltration. We also tested the hydroxyproline concentration in wound tissue at 3 and 7 days after surgery and found that the concentration were significant higher in Shuruiji group(p<0.05) and the Surgicel group(p<0.05) compared with the control group.The result of abdominal adhesions model showed that: there were significant adhesions with other intestine in control group, but portion adhesions in the Shuruiji group and the Surgicel group. The adhesion score of Surgicel group and the Shuruiji group was significant lower than the control group(p<0.05). Adhesions results showed cecal serous layer in the control group had a large number of collagen fibers and hyperplasia of cardiovascular, but in Surgicel group and Shuruiji group it turn thicken. Furthermore, the concentration of hydroxylproline in the Shuruiji group and the Surgicel group was significantly lower than the control group(p<0.05).Conclusions:(1) Shuruiji has significant hemostatic effect in canine liver trauma,it can significantly shorten the bleeding time and applicable to diffuse bleeding and can promote the wound healing, meanwile it has no significant side effects.(2) Shuruiji has a certain anti-blocking effect, and can significantly reduce the incidence of peritoneal adhesions and peritoneal adhesions after surgery.