ASSESSMENT OF THE ADHESION PROCESS AFTER LIVER INJURY IN CHRONIC EXPERIENCE

Background. The issue of studying the reaction of a macroorganism to use of various local hemostatic agents is relevant. In particular, an important factor for use of a certain hemostatic agent in practical medicine is the low probability of formation of adhesions in the postoperative period after its implantation. Aim. Was to investigate the peculiarities of the course of adhesion process in the abdomen of laboratory animals after liver injury and stoppage of bleeding by local spongy hemostatic agents in an experiment. Materials and Methods. As materials, various samples of spongy hemostatic agents were used: Tachocomb®, Na-CMC + tranexamic acid, Na-CMC. The study was performed on male rabbits of the «Soviet chinchilla» breed (10 in each experimental group) in the operating unit of the laboratory of experimental surgery and oncology of the Research Institute of Experimental Medicine of KSMU. Surgical intervention was performed using a video-surgical complex, a liver wound was formed, and to stop bleeding, the studied samples of hemostatic sponges were used. Before surgery and on the 1st, 3rd, 7th, 15th, 30th day after surgery each animal was made the control dynamic laparoscopy, in which the evidence and spread of peritoneal adhesions were macroscopically evaluated. Results. In the group where Tachocomb® collagenous plate was used for arrest of bleeding, practically no statistically significant differences were found in comparison of the results of control dynamic laparoscopy (CDL) – on the 1st day after injury, there was no active bleeding and adhesions, on the 30th day a decrease in the area of growth of connective tissue structures was noted in the region of injury, and the color of parenchyma was comparable with that of intact areas. The parameters were analyzed both within the group (at different periods of the experiment) and between the experimental groups. Conclusions. In the intra-group comparison, a small number of significant differences were noted which may evidence comparability of the adhesive process at different periods of the experiment in the study groups. In practically of all cases of adhesion, they attached to the anterior abdominal wall at the point of insertion of the cannula for laparoscope (or quite close to it) that may be associated with frequent trauma of the peritoneum in this region provided by the design of the experiment, and in all cases threadlike adhesions were found, the morphological substrate of which was a strand of greater omentum. There were no clinical manifestations of adhesive intestinal obstruction in laboratory animals.