Use of a local hemostatic agent based on chitosan and external compression of the abdominal area to control intra-abdominal bleeding

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Abstract

The paper presents the intermediate results of an experimental study of three samples of chitosan-based local hemostatic agent in a model of intense intra-abdominal bleeding in an average-sized experimental animal (a Soviet Chinchilla rabbit) with a standard wound on the parenchymal organ (liver) in combination with external compression of the abdominal area to achieve hemostasis in the acute phase of the experiment. At the first stage, nine experimental groups and one control group, with three biological objects each, were involved (n = 30). The composition and properties of laboratory preparations of hemostatics were different from the concentration of the main component. To select the optimal sample of a local hemostatic agent with the least local irritant effect on the organs and structures of the abdominal cavity, three experimental groups with three animals each were formed at the second stage, without modeling blood loss (n = 9) with follow-up from 24 to 72 h. The studied drugs have high hemostatic activity in the model of intense intra-abdominal bleeding with follow-up periods from several hours to 3 days. Moreover, intraperitoneal administration of hemostatic agent samples does not lead to a pronounced local irritant effect. However, during the first 180 min of the experiment, only one fatal outcome was recorded in a group of animals with 15% chitosan in the studied drug because of a technical error in modeling the source of bleeding. External compression of the abdominal area demonstrated its effectiveness as an auxiliary technique for temporary control of the intra-abdominal source of bleeding in the experimental model. The objectification of the obtained results was achieved through a control sectional study and laboratory screening of peripheral blood indicators of experimental animals at different stages of the experiment. To further evaluate the hemostatic activity of chitosan-based drugs, creating an experimental model using a large experimental animal is necessary.

About the authors

Konstantin P. Golovko

Military medical academy of S.M. Kirov; Saint Petersburg State University

Author for correspondence.
Email: vmeda-nio@mail.ru
ORCID iD: 0000-0002-1584-1748
SPIN-code: 2299-6153

doctor of medical sciences, associate professor

Russian Federation, Saint Petersburg; Saint Petersburg

Igor M. Samokhvalov

Military medical academy of S.M. Kirov

Email: igor-samokhvalov@mail.ru
SPIN-code: 4590-8088

doctor of medical sciences, professor

Russian Federation, Saint Petersburg

Maxim S. Grishin

Military medical academy of S.M. Kirov

Email: al13max@mail.ru
ORCID iD: 0000-0003-0846-3432
SPIN-code: 8766-2055

adjunct

Russian Federation, Saint Petersburg

Artem M. Nosov

Military medical academy of S.M. Kirov

Email: artem_svu06@mail.ru
ORCID iD: 0000-0001-9977-6543
SPIN-code: 7386-3225

candidate of medical sciences

Russian Federation, Saint Petersburg

Andrey B. Yudin

State Research Testing Institute of Military Medicine

Email: yudin_a73@mail.ru
SPIN-code: 7060-1221

candidate of medical sciences

Russian Federation, Saint Petersburg

Arkady Y. Kovalevsky

Military medical academy of S.M. Kirov

Email: kovalevskiy.arkadiy@mail.ru
SPIN-code: 1630-7857

student

Russian Federation, Saint Petersburg

Andrey S. Bagnenko

Military medical academy of S.M. Kirov; Saint Petersburg State University

Email: BagnenkoA.S.MFS@mail.ru
ORCID iD: 0000-0002-9293-4390
SPIN-code: 4360-6869

candidate of medical sciences

Russian Federation, Saint Petersburg; Saint Petersburg

Ivan M. Kovalishin

Saint Petersburg State University

Email: ikovalishin52@gmail.com

ultrasound diagnostics doctor

Russian Federation, Saint Petersburg

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Sizing before applying liver wound

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3. Fig. 2. Introduction of the hemostatic agent to the source of intra-abdominal bleeding

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4. Fig. 3. Local hemostatic agent “0401” when observed for 180 min. Effective hemostasis. The bulk of the drug is soaked in blood

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5. Fig. 4. Complex “preparation-surrounding tissues.” Fibrin are found at the site administered with hemostatic “0103-20” after 72 h

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6. Fig. 5. Fixation of the drug “0401” to the loops of the small and large intestines. No data were obtained for acute intestinal obstruction. The observation period was 72 h

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7. Fig. 6. Changes in the abdominal organs 72 h after the administration of hemostatic “0103-20”

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Copyright (c) 2022 Golovko K.P., Samokhvalov I.M., Grishin M.S., Nosov A.M., Yudin A.B., Kovalevsky A.Y., Bagnenko A.S., Kovalishin I.M.

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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