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

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.