Authors
Zdanevich I.V.1, Yarosh A.L.1, Soloshenko A.V.1, Oleinik N.V.1, Goryainova G.N.2, Babaeva M.A.2
1 Belgorod State National Research University, Belgorod
2 Kursk State Medical University, Kursk
Abstract
Rationale: One of the main causes of exudative complications in surgical practice is the difficulty of ensuring reliable hemostasis. The problem of preventing wound exudative complications during endoprosthetics of the anterior abdominal wall leaves many questions for discussion, and requires the search for new hemostatic agents and techniques to solve this problem. To date, there are a large number of tools for local hemostasis, however, work reflecting their use in endoprosthetics of the anterior abdominal wall is extremely rare. The introduction of this group of drugs into practice will significantly improve the surgical arsenal of preventive measures and reduce the number of local bleeding, seromas and hematomas.
Objective: to evaluate the effectiveness of the use of a hemostatic drug in conditions of simulated local bleeding in the area of the anterior abdominal wall endoprosthesis.
Methods: The experimental part of the work was performed on 64 male Wistar rats. A randomized scheme was formed for dividing experimental animals into two equal groups: the main and the control. During the surgical intervention, all animals underwent the implantation of an Esfil mesh endoprosthesis with simultaneous modeling of a bleeding lesion. In the individuals of the main group, the drug Statin Palm was used for hemostasis, whereas in the control group the drug was not used. The material was collected on days 1, 2, 3 and 10 after surgery. Using an overdose of ether anesthesia, tissue samples of the anterior abdominal wall were taken with complete capture of the muscle layer and the implant. For histological analysis, staining of sections using the Zerbino and Lukasevich method was used, which made it possible to carry out a differentiated assessment of the age of fibrin deposits and analyze the effect of a hemostatic agent on the dynamics of the reparative process.
Results: When using the hemostatic drug Statin Palma, a reduction in the intensity of exudative processes and the absence of exudative formations were noted. In the control group, 25% of the animals exhibited exudative complications (seromas) by the tenth day of the experiment, caused by ongoing bleeding. In addition to its primary hemostatic effect, the hemostatic drug Statin Palma also positively influences the acceleration of reparative processes in the implantation area. This is evidenced by the faster maturation and transformation of fibrin into its mature form, which was observed as early as the second day of the experiment in the group treated with Statin Palma.
Conclusion: The use of Statin palm in patients with active bleeding is effective in improving the quality of hemostasis during endoprosthetics of the anterior abdominal wall complicated by bleeding. This technique will reduce the number of exudative complications in the postsurgical period and improve wound healing processes.
Keywords: experiment, endoprosthetics, bleeding, hemostatic drugs, exudative complications, hematoma.
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