Comparison of hemostatic efficacy of topical Ankaferd Blood Stopper on heparinized and nonheparinized rats in bleeding related to liver injury

ABSTRACT Purpose: In this study, hemostatic efficacy of Ankaferd Blood Stopper (ABS), a new generation hemostatic agent, was compared in the presence of heparin effect. Methods: Forty-eight Wistar albino rats were divided into two main groups as heparinized and nonheparinized, and these two main groupswere divided into six subgroups as control, Surgicel and ABS (n = 8). Grade 2 liver injury was performed on rats as standard. All groups were compared in terms of weight, laceration surface area, prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR), bleeding time, bleeding amount, hemoglobin (Hb) levels, macroscopic and microscopic reactions to the agent used. Results: Whereas there was no statistically significant difference between weight, laceration surface area, PT, INR and preoperative Hb values in the heparinized and nonheparinized groups, postoperative Hb, bleeding time, bleeding amount and aPTT values were statistically different (p < 0.05). In the heparin-hemostat interaction, the ABS group had the lowest bleeding in the heparinized group in terms of the amount of bleeding compared to the control and Surgicel groups (F = 0.764; p = 0.047). In macroscopic and microscopic comparison, there was no difference between the groups in terms of cell necrosis andfresh bleeding (p > 0.05), it was found that the Surgicel group had statistical significantly higher reaction scores (p < 0.05) than the other groups in terms of other parameters. Conclusions: Ankaferd Blood Stopper can be safely and effectively used in surgical practice and in patients with additional diseases requiring heparinization, since it causes minimal reaction in the liver and decreases the amount of bleeding especially in the heparinized group.

An Effects of Hemostatic Materials on Cranial Bone Osteogenesis in Rabbit

The influence of hemostatic materials in split thickness calvarial bone defects was evaluated in 24 white rabbit models. The rabbits were divided in 4 groups. In the group A, Surgicel(R) was inserted into the 2x2cm sized left calvarial defects. In the group B, Gelfoam(R) was inserted and in group C, Bonewax(R) was inserted and in group D, Collagen bloc was inserted. The contralateral side underwent sham operation as the control group. After 4 and 8 weeks, radiological findings, histopathological findings and immunohistopathological findings were studied to find development of trabeculae, appearance of osteoblast, calcification and increased expression of TGF-beta. As a result, osteoid and osteoblast were richly found in Surgicel(R), Gelfoam(R), Collagen bloc inserted groups. In Bonewax(R) inserted group, bone regeneration was delayed and foreign body reaction was seen in 4 weeks and it reduced in 8 weeks. The TGF-beta was darkly stained in periosteum, connective tissue and periphery of bone defect. From this result it would be concluded as follows. Surgicel(R), Gelfoam(R) and Collagen bloc effects positively on bone healing with marked increasing of osteoid, osteoblasts and rapid bone remodeling. Bonewax(R) prolongs bone healing with increasing foreign body reaction. Bone regeneration was confirmed with increased expression of TGF-beta in Surgicel(R), Gelform(R) and Collagen bloc applied groups especially in periosteum and ends of bone defects. It suggests that bone regeneration was originated from these areas.