Сеченовский вестник (Mar 2020)

Study of the effect of the concentration of sodium carboxymethylcellulose on hemostatic and antiadhesive activity during liver operations in an experiment

  • D. S. Soldatova,
  • A. I. Bezhin,
  • T. N. Kudryavtseva

DOI
https://doi.org/10.47093/2218-7332.2020.11.1.4-14
Journal volume & issue
Vol. 11, no. 1
pp. 4 – 14

Abstract

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Liver surgeries are associated with the risk of bleeding and the development of adhesive disease. Sodium carboxymethylcellulose (Na-CMC) forms an elastic swelling gel and a “lattice” that holds the blood cells.The aim: determine the concentration of Na-CMC, which has the maximum hemostatic and anti-adhesive effect, during liver surgeries in the experiment.Materials and methods. The coagulating effect of Na-CMC (from 0.5% to 9%) was studied in vitro. In vivo experiment on 167 male Wistar rats weighing 185–250 g studied the bleeding time and the amount of blood loss, anti-adhesive activity in the model of liver surgery by cutting off the edge of the organ in the standard way: the depth and width of the wound is 1 cm; the height is 3 mm.Results. In vitro the minimum coagulating effect was obtained in 3% of Na-CMC. In vivo the maximum effect on reducing the bleeding time (–46% compared to the control, p < 0.01) and the amount of blood loss (–27% compared to the control, p < 0.01) had 6% Na-CMC. Then, according to the degree of decrease in the bleeding time, there were: 5% Na-CMC (–40%), 4% Na-CMC (–37%), 3% Na-CMC (–29%), 7% Na-CMC (–27%), 8% Na-CMC (–11%). For the amount of blood loss, a similar pattern of decreasing effect was observed: 5% Na-CMC (–21%), 4% Na-CMC (–14%), 7% Na-CMC (–12%), 3% Na-CMC (–11%), 8% Na-CMC (–5%). When comparing all the studied concentrations of Na-CMC gel with the control group in terms of bleeding time and blood loss, the differences are statistically significant: p < 0.01. Maximum anti-adhesive activity was observed for 6% Na-CMC on days 7 and 14 after surgery: the adhesive process was estimated at 0.497 [0.000–0.497] and 0.962 [0.000–1.301] points vs. 2.457 [2.118–2.457] and 4.071 [3.758–4.602] points in the control group (p < 0.01).Conclusion. The maximum hemostatic and anti-adhesive effect has 6% Na-CMC.

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