Ciddi femoral arter ve ven kanamas� olan deneysel koyun modelinde, lokal �chitosan linear polymer� gran�l uygulaman�n, hemostatik etkinli�i

Ersoy, G�rkan; Rodoplu, �lk�men; Y�lmaz, Osman; G�kmen, Necati; Do�an, Alper; Dikme, �zg�r; Ayd�no�lu, Asl�; Orhon, Okyanus

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Turkish Journal of Trauma and Emergency Surgery Ciddi femoral arter ve ven kanamas� olan deneysel koyun modelinde, lokal �chitosan linear polymer� gran�l uygulaman�n, hemostatik etkinli�i [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2016; 22(3): 215-223 | DOI: 10.5505/tjtes.2015.16689

Ciddi femoral arter ve ven kanamas� olan deneysel koyun modelinde, lokal �chitosan linear polymer� gran�l uygulaman�n, hemostatik etkinli�i

G�rkan Ersoy¹, �lk�men Rodoplu², Osman Y�lmaz³, Necati G�kmen⁴, Alper Do�an⁵, �zg�r Dikme⁶, Asl� Ayd�no�lu⁷, Okyanus Orhon⁸
¹Dokuz Eyl�l �niversitesi T�p Fak�ltesi Hastanesi, Acil T�p Anabilim Dal�, �zmir
²Aile Hekimli�i Uzman�, �zmir
³Dokuz Eyl�l �niversitesi T�p Fak�ltesi Hastanesi, Deney Hayvanlar� Bilimi, Anabilim Dal�, �zmir
⁴Dokuz Eyl�l �niversitesi T�p Fak�ltesi Hastanesi, Anesteziyoloji Ve Reanimasyon Anabilim Dal�, �zmir
⁵Devlet Hastanesi, Anestezi Klini�i, Denizli
⁶�stanbul E�itim Ve Ara�t�rma Hastanesi Acil T�p Klini�i, �stanbul
⁷Medikal Park Hastanesi, Acil T�p Anabilim Dal�, �zmir
⁸Denizcilik Y�neticili�i, Gemi Kurtarma Uzman�, Uzakyol Vardiya Zabiti (3. Kaptan), �stanbul

AMA�: Femoral kanamal�, deneysel koyun modelinde, �chitosan linear polymer� uygulamas�n�n, hemostatik etkinli�ini ara�t�rmay� ama�lad�k.
GERE� VE Y�NTEM: Koyunlar�n anestezi ve ent�basyonunu takiben, kanamay� ba�latmak i�in kas�k yaralanmas� olu�turuldu. Denekler, �al��ma ve kontrol gruplar� �eklinde randomize edildiler. Kontrol grubunda, kanama alan� �st�ne absorban pedler yerle�tirildi ve �st�ne a��rl�k konarak bas� olu�turuldu. �al��ma grubunda ise kanama alan�na �chitosan linear polymer� d�k�ld�, absorban pedler ve a��rl�k ayn� �ekilde yerle�tirildi. Her be� dakikada bir kanama de�erlendirildi. Ana ��kt� kanama duruncaya kadar ge�en zamand�.
BULGULAR: �al��ma grubunda kanama, be� denekte ilk, di�er denekte ise ikinci giri�imde durdu. Bir denek �al��madan ��kar�ld�. Kontrol grubunda, kanama bir denekte ilk giri�imde, d�rt denekte ikinci giri�imde, iki denekte ise, yerin dikilmesinden sonra durdu. Hemostaz �al��ma grubunda, kontrol grubuna oranla, daha erken d�nemde sa�land� ve her iki grup aras�ndaki fark, istatistiksel olarak anlaml� idi.
TARTI�MA: Bu koyun modelinde �chitosan linear polymer� uygulamas� hemostaz� kontrol grubuna g�re daha k�sa s�rede sa�lad�.

Anahtar Kelimeler: Eksternal kanama, kitosan lineer polimer, kontrols�z kanama, travma.

Hemostatic efficacy of local chitosan linear polymer granule in an experimental sheep model with severe bleeding of arteria and vena femoralis

G�rkan Ersoy¹, �lk�men Rodoplu², Osman Y�lmaz³, Necati G�kmen⁴, Alper Do�an⁵, �zg�r Dikme⁶, Asl� Ayd�no�lu⁷, Okyanus Orhon⁸
¹University Of Dokuz Eyl�l, School Of Medicine, Department Of Emergency Medicine, �zmir
²Family Physician (private Doctor), �zmir
³University Of Dokuz Eyl�l, School Of Medicine, Department Of Laboratory Animals Science, �zmir
⁴University Of Dokuz Eyl�l, School Of Medicine, Department Of Anesthesiology And Reanimation, �zmir-turkey.
⁵Department Of Anesthesiology, State Hospital Of Denizli, Denizli
⁶Research And Educational Hospital Of �stanbul, Department Of Emergency Medicine, �stanbul
⁷Department Of Emergency Medicine, Medical Park Hospital, �zmir
⁸Maritime Management, Salvage Master (vessel Recovery, Wreck Removal For Ship) And Oil Spill Specialist. Oceangoing Watchkeeper, �stanbul

BACKGROUND: The aim of the present study was to evaluate the hemostatic effect of chitosan linear polymer in a sheep model with femoral bleeding.
METHODS: Following induction of anesthesia and intubation of sheep, groin injury was induced to initiate hemorrhage. Animals were randomly assigned to study and control groups. In the control group, absorbent pads were packed on the wound, and pressure was supplied by a weight placed over the dressing. In the study group, chitosan linear polymer was poured onto the bleeding site; absorbent pads and pressure were applied in the same manner. At 5-min intervals, bleeding was evaluated. Primary endpoint was time to hemostasis.
RESULTS: Bleeding had stopped by the 1st interval in 5 members of the study group, and by the 2nd interval in 1 member. One sheep was excluded. The bleeding stopped after the 1st interval in 1 member of the control group and after the 2nd interval in 4 members. Bleeding stopped in 2 cases following ligation of the bleeding vessel. Hemostasis was achieved earlier in the study group, compared to the control group, and the difference was statistically significant.
CONCLUSION: Hemostasis was achieved earlier following application of chitosan linear polymer.

Keywords: Chitosan linear polymer, external bleeding, trauma, uncontrolled hemorrhage.

Sorumlu Yazar: G�rkan Ersoy, T�rkiye
Makale Dili: �ngilizce

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