Aim of research: to study the comparative effectiveness of new polycompositive of hemostatic implant on in vivo model of liver parenchymal bleeding.Material and methods. Experimental studies were performed using the developed polycompositive hemostatic implant (CPM) from cellulose derivatives. Main components of implant include: natrium carboxymethylcellulose, oxidized cellulose, nanocellulose and bonded calcium ions. In vivo experiments were conducted in both sexes white 24 utbred rats weighing 196.5 ± 2.8 grams. The animals were divided into two groups: the comparative group (n = 24) with an application of polycomposite hemostatic implant and main group (n = 24) with medical gauze. The hemostatic materials were used in equal weight 30 mg. All surgical procedures on animals were performed under general inhalation anesthesia in model of liver parenchymal bleeding.Results. Thus, hemostasis was reached within 34.0 ± 2.5 seconds in the main group with CPM, in the comparative group with medical gauze — 142.2±7.7 seconds. Repeated bleeding was observed in 11 (45.8%) cases of the comparative group and in the main group — 2 (8.3%) cases. Biodegradation of the hemostatic implant and regenerative processes in the liver parenchyma were registered on the 14 day, especially in the injured area that indicates the restoration of liver tissue. In the comparative group on the 30th day, the preservation of medical gauze structure was revealed without degradation signs.Findings. According to our research data, a polycompositive hemostatic implant adheres tightly to the liver tissue, stops bleeding without its recurrence. In histological studies conducted in the dynamics of wound healing of the liver it was found that the implant does not cause a severe inflammatory reaction and biodegradation occurs after 14 days.
Aim. This study was done to determine the feasibility and effectiveness of the proposed method of thoracoscopic hemostasis and aerostasis. Methods. The study included 85 patients operated for bullous lung disease, closed chest injury and penetrating chest wounds in the Lung and Mediastinum surgery department of the Republican Specialized Scientific and Practical Medical Center of Surgery named after Academician V.Vakhidov for the period from 2015 to 2019. Total of 33 patients made up the main group: thoracoscopy using the proposed technique and 52 patients for the comparison group: thoracoscopic aerostasis was performed using known methods. In 21 (40.4%) cases of comparison group, we performed video-assisted thoracoscopic (VATS) excision and suturing with pleurodesis; in 14 (26.9%) cases -VATS with stitching of a lung wound. VATS excision and flashing of bullae of the lung using a stapler was performed in 19.2% (10 of 52) cases of the comparison group and 24.2% in the main group, where all VATS were supplemented with Geprotsel gel application. Results. Using the Geprotsel in VATS interventions allowed to reduce the necessity of lung tissue stitching from 67.7% to 27.3%, respectively, to limit excision in 36.4% of patients, to achieve complete tightness after hardware stitching (χ 2 -17.304; Df=3; p<0.001), which generally leveled the risk of postoperative pneumonia and impaired hemostasis. Recommendation. We suggest that applying Geprotsel gel during VATS for lung tissue damages allows to reduce the application of additional sutures, improve the efficiency of minimally invasive operations with a decrease in the frequency of postoperative disorders of aero-and hemostasis.
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