Adamiak Zbigniew, Borys Jan, Krystkiewicz Wioletta, Pomaniowski Andrzej, Jalynski Marek, Holak Piotr, Brzezinski Maciej, Jastrzebski Pawel, Tobolska Angelika, Glodek Joanna
Department of Surgery and Radiology, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland.
Department of Craniomaxillofacial Surgery, USK Białystok, Białystok, Poland.
In Vivo. 2019 Mar-Apr;33(2):359-363. doi: 10.21873/invivo.11482.
BACKGROUND/AIM: Coagulopathy can develop when hemostatic dressings are used to stop massive bleeding, even in patients without prior history of clotting disorders. The selection of procoagulants, which effectively control bleeding and prevent disseminated intravascular coagulation (DIC) and thrombosis, is a significant challenge. The aim of this study was to evaluate the effect of two prototypes of haemostatic dressing in the porcine haemostatic system.
The total number of animals used in our experiments was 24. Group I: pigs were treated with the developed prototype of sponge dressing, made of Na-Ca chitosan/algal composite of microfibers and nanofibers. Group II: animals were treated with a seton gauze modified with a polymer mixture of Na-Ca chitosan/algal composite of microfibers and nanofibers. Group III: animals were treated with non-hemostatic dressing and this group was the control. Blood was sampled five times to determine changes in the coagulation and fibrinolytic profiles: before injury: i) at 1 h, ii) at 24 h, iii) at 7, and iv) at 14 days following injury.
Significant changes were observed in the coagulation parameters, in the total numbers of white blood cells and platelets in groups I and II, compared to controls.
The modified haemostatic dressings used in this study produced a strong procoagulant effect in pigs. This, together with high fibrinogen concentrations, which can cause DIC, require further studying.
背景/目的:即使在没有凝血障碍病史的患者中,使用止血敷料来止血时也可能发生凝血病。选择能有效控制出血并预防弥散性血管内凝血(DIC)和血栓形成的促凝剂是一项重大挑战。本研究的目的是评估两种止血敷料原型在猪止血系统中的效果。
我们实验中使用的动物总数为24只。第一组:用由钠 - 钙壳聚糖/藻类复合微纤维和纳米纤维制成的新型海绵敷料原型治疗猪。第二组:用由钠 - 钙壳聚糖/藻类复合微纤维和纳米纤维的聚合物混合物改良的挂线纱布治疗动物。第三组:用非止血敷料治疗动物,该组为对照组。在五个时间点采集血液样本以确定凝血和纤溶指标的变化:受伤前;受伤后1小时、24小时、7天和14天。
与对照组相比,第一组和第二组的凝血参数、白细胞和血小板总数有显著变化。
本研究中使用的改良止血敷料在猪中产生了强烈的促凝作用。这与可能导致DIC的高纤维蛋白原浓度一起,需要进一步研究。