关键词: 氧化再生纤维素, 可吸收止血材料, 肝脏出血创面, 可吸收止血纱, 动物模型, 止血效果

Abstract: BACKGROUND: At present, plant-derived absorbable hemostats are mainly imported, so it is necessary to develop domestic alternatives that are not inferior to similar imported products.
OBJECTIVE: To investigate the hemostatic effect of oxidized regenerated cellulose hemostatic material on a model of minipig liver hemorrhage.
METHODS: A total of 24 Bama minipigs were selected and randomly divided into three groups. In the sham operation group (n=6), only an open operation was performed, and the damaged side of the liver was removed and put back in situ. In the experimental group (n=12), the liver hemorrhage model was established, and the oxidized regenerated cellulose hemostatic material was applied to the wound. In the control group (n=6), commercially available absorbable hemostatic gauze was used on the wound after establishing liver hemorrhage models. Hemostatic time and blood loss were recorded. The venous blood of the minipig anterior cavity was collected at different time points before and after modeling, and the blood routine and liver and kidney functions were analyzed. Hematoxylin-eosin staining and Masson staining were performed at 2, 6, and 14 weeks after modeling. The main organs were observed by histopathology at 14 weeks after modeling. A liver ultrasound examination was performed at different time points after modeling to observe the degradation and absorption of materials.
RESULTS AND CONCLUSION: (1) There was no significant difference in intraoperative hemostatic time and blood loss between the experimental group and the control group (P > 0.05). (2) The monitoring results of blood biochemical indexes demonstrated that the levels of aspartate transaminase and glutamic pyruvic transaminase in the three groups were higher 24 hours after modeling than before modeling, and the indexes basically recovered to the normal levels 72 hours after modeling. There were no significant differences in blood biochemical indexes such as liver and kidney functions, blood glucose and inflammatory factors among the three groups (P > 0.05). (3) Hematoxylin-eosin staining and Masson staining of histopathology revealed that 2 weeks after surgery, granulation tissue formation and a large amount of collagen fiber deposition were observed on the liver wounds of the two groups, and there were obvious fibrous hyperplasia zones and inflammatory cell infiltration, and the wound healed well. 14 weeks after modeling, the liver wounds of two groups of minipigs exhibited mild fibrous hyperplasia zone, collagen fiber deposition and a small amount of inflammatory cell infiltration, complete material degradation, and the healed wound. Hematoxylin-eosin staining showed no significant pathological changes in major organs. (4) Ultrasonic examination demonstrated that the materials of both groups were degraded gradually with the extension of implantation time, and most of them were degraded and absorbed by 56 days after molding. (5) The results confirm that the oxidized regenerated cellulose hemostatic material can effectively prevent liver wound hemorrhage in minipigs, and the hemostats are safe and reliable.

Key words: oxidized regenerated cellulose, absorbable hemostatic material, liver hemorrhage wound, absorbable hemostatic gauze, animal model, hemostatic effect