Abstract
A number of hemostatic agents such as porcine collagen, topical thrombin, and SURGICEL (oxidized cellulose) can be used to achieve homeostasis in liver laceration. This study aims to compare stereological findings in using SURGICEL vs. gauze packing in grade 4 liver lacerations in Wistar rats. In this experimental study, 20 male Wistar-albino rats weighing 250–300 g were purchased from Shiraz University of Medical Sciences animal laboratory. At the beginning of the study, a 1-cm length and 0.5-cm depth linear laceration was made on the large lobe of the liver in all rats through laparotomy. At least one or more liver tissue samples were obtained from live rats to compare the efficacy of SURGICEL vs. gauze packing. According to our stereological results, normal liver tissue in the SURGICEL group (0.882 ± 0.146) was significantly lower than the controls (0.994 ± 0.007) (p value < .016). Liver fibrosis in the SURGICEL group (0.043 ± 0.025) was significantly more than the control group (0.005 ± 0.007) (p value < .016). As known, by increase in the fibrosis tissue, the chance of recurrent bleeding decreases; analysis of the results showed that we had more fibrosis tissue after treatment of liver laceration by SURGICEL instead of gauze and it is a new hope in liver laceration treatment methods.
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Abe S, Jovanovic I, Neumann H, Saito Y, Klaus M (2015) Mo1532 feasibility and usefulness of application of oxidized cellulose (Surgicel) to treat and prevent hemorrhage after large endosocpic colorectal resections. Gastrointest Endosc 81:AB455
Afifi RY (2008) Blunt abdominal trauma: back to clinical judgement in the era of modern technology. Elsevier
Amirbeiky TM, Davoud AA, Amirbeigy M (2014) Evaluating frequency and cause of laparotomy in penetrating and blunt abdominal trauma in at Shahid Beheshti Hospital of Kashan during the years 2009–2012
Asensio JA, Demetriades D, Chahwan S, Gomez H, Hanpeter D, Velmahos G, Murray J, Shoemaker W, Berne TV (2000) Approach to the management of complex hepatic injuries. J Trauma Acute Care Surg 48:66
Bala M, Gazalla SA, Faroja M, Bloom AI, Zamir G, Rivkind AI, Almogy G (2012) Complications of high grade liver injuries: management and outcome with focus on bile leaks. Scand J Trauma Resusc Emerg Med 20(20):20
Feliciano DV, Mattox KL, Burch JM, Bitondo CG, Jordan JG (1986) Packing for control of hepatic hemorrhage. J Trauma 26:738–743
Ferretti L, Qiu X, Villalta J, Lin G (2012) Efficacy of BloodSTOP iX, Surgicel, and Gelfoam in rat models of active bleeding from partial nephrectomy and aortic needle injury. Urology 80:1161.e1-6
Frantz VK, Lattes R (1945) Oxidized cellulose—absorbable gauze:(cellulosic acid). J Am Med Assoc 129:798–801
Genyk Y, Kato T, Pomposelli JJ, Wright JK Jr, Sher LS, Tetens V, Chapman WC (2016) Fibrin sealant patch (TachoSil) vs oxidized regenerated cellulose patch (Surgicel original) for the secondary treatment of local bleeding in patients undergoing hepatic resection: a randomized controlled trial. J Am Coll Surg 222:261–268
Inaba K, Rhee P, Teixeira PG, Barmparas G, Putty B, Branco BC, Cohn S, Demetriades D (2011) Intracorporeal use of advanced local hemostatics in a damage control swine model of grade IV liver injury. J Trauma Acute Care Surg 71:1312–1318
Kakaei F, Sadeghi S, Salim M, Sanei B, Hashemzadeh S, Habibzadeh A (2013) A randomized clinical trial comparing the effect of different haemostatic agents for haemostasis of the liver after hepatic resection. HPB Surgery 2013
Karakaya K, Ucan HB, Tascılar O, Emre AU, Cakmak GK, Irkorucu O, Ankarali H, Comert M (2009) Evaluation of a new hemostatic agent Ankaferd Blood Stopper in experimental liver laceration. J Investig Surg 22:201–206
Lewis K, Spazierer D, Urban M, Lin L, Redl H, Goppelt A (2013) Comparison of regenerated and non-regenerated oxidized cellulose hemostatic agents. Eur Surg 45:213–220
Malhotra AK, Ivatury R, Latifi R (2002) Blunt abdominal trauma: evaluation and indications for laparotomy. Scand J Surg 91:52–57
Matsuda H, Ando S, Kato T, Morikawa T, Yoshikawa M (2006) Inhibitors from the rhizomes of Alpinia officinarum on production of nitric oxide in lipopolysaccharide-activated macrophages and the structural requirements of diarylheptanoids for the activity. Bioorg Med Chem 14:138–142
Motie M, Behnampour N, Alinezhad H (2009) Epidemiology of blunt abdominal trauma in Gorgan-Iran (2001–05). J Gorgan Univ Med Sci 10:55–86
Nouri S, Sharif M (2015) Investigating the effect of zinc chloride on control of liver hemorrhage; an animal model study. J Isfahan Med School 32:1845–1854
Okumuş M et al (2013) Medicinal plant extract (Ankaferd Blood Stopper) application in deep tissue injuries in rats: histopathological investigation of the effect on regional and systemic tissues. Ulus Travma Acil Cerrahi Derg 19:1–7
Pierce A, Wiebkin O, Wilson D (1984) Surgicel®: its fate following implantation. J Oral Pathol Med 13:661–670
Satar NYG, Akkoc A, Oktay A, Topal A, Inan K (2013) Evaluation of the hemostatic and histopathological effects of Ankaferd Blood Stopper in experimental liver injury in rats. Blood Coagul Fibrinolysis 24:518–524
Sharma J, Malhotra M, Pundir P (2003) Laparoscopic oxidized cellulose (Surgicel) application for small uterine perforations. Int J Gynecol Obstet 83:271–275
Singh V, Narasimhan KL, Verma GR, Singh G (2007) Endoscopic management of traumatic hepatobiliary injuries. J Gastroenterol Hepatol 22:1205–1209
Sirlak M, Eryilmaz S, Yazicioglu L, Kiziltepe U, Eyileten Z, Durdu MS, Tasoz R, Eren NT, Aral A, Kaya B, Akalin H (2003) Comparative study of microfibrillar collagen hemostat (Colgel) and oxidized cellulose (Surgicel) in high transfusion-risk cardiac surgery. J Thorac Cardiovasc Surg 126:666–670
Spotnitz WD, Burks S (2010) State-of-the-art review: hemostats, sealants, and adhesives II: update as well as how and when to use the components of the surgical toolbox. Clin Appl Thromb Hemost 16:497–514
Testai L, Chericoni S, Calderone V, Nencioni G, Nieri P, Morelli I, Martinotti E (2002) Cardiovascular effects of Urtica dioica L.(Urticaceae) roots extracts: in vitro and in vivo pharmacological studies. J Ethnopharmacol 81:105–109
Tinkoff G, Esposito TJ, Reed J, Kilgo P, Fildes J, Pasquale M, Meredith JW (2008) American Association for the Surgery of Trauma Organ Injury Scale I: spleen, liver, and kidney, validation based on the National Trauma Data Bank. J Am Coll Surg 207:646–655
Wahl WL, Brandt M-M, Hemmila MR, Arbabi S (2005) Diagnosis and management of bile leaks after blunt liver injury. Surgery 138:742–748
Yuan K-C, Wong Y-C, Fu C-Y, Chang C-J, Kang S-C, Hsu Y-P (2014) Screening and management of major bile leak after blunt liver trauma: a retrospective single center study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 22:26
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The authors would like to acknowledge the Research Center of Shiraz University of Medical Science for improving the use of English in the manuscript.
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All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. Ethics number: ir.bmsu.rec.1396.418.
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Khoshmohabat, H., Paydar, S., Karami, M.Y. et al. SURGICEL compared with simple gauze packing in grade IV liver injury: an experimental study. Comp Clin Pathol 28, 467–471 (2019). https://doi.org/10.1007/s00580-018-2880-5
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DOI: https://doi.org/10.1007/s00580-018-2880-5