Ulus Travma Acil Cerrahi Derg. 2022; 28(8): 1059-1065 | DOI: 10.14744/tjtes.2022.90838

Hemostatic effects of traditional Inula viscosa and Capsella bursa-pastoris plant mixture extract on rat liver parenchymal bleeding model

Ozan Utku Öztürk¹, Mustafa Ugur¹, Yelda Güzel², Mehmet Ali Öztürk³, Didar Gürsoy⁴, Serdar Doðan⁵, Muhyittin Temiz^1
1Department of General Surgery, Hatay Mustafa Kemal University Faculty of Medicine, Hatay-Türkiye
²Department of Biology, Hatay Mustafa Kemal University Faculty of Arts and Science, Hatay-Türkiye
³Institute of Biology, University of Freiburg, Freiburg-Germany
⁴Department of Pathology, Hatay Mustafa Kemal University Faculty of Medicine, Hatay-Türkiye
⁵Department of Biochemistry, Hatay Mustafa Kemal University Faculty of Medicine, Hatay-Türkiye

BACKGROUND: Failure to achieve effective bleeding control and problems related to transfusion in liver surgery are the most common causes of post-operative mortality and morbidity. Various methods/drugs including topical hemostatic agents have been em-ployed for bleeding control in liver surgery. This study was aimed to investigate the hemostatic properties of the herb mixture extract of Inula viscosa and Capsella bursa-pastoris (IvCbp) in rat liver laceration model, which have been traditionally used as antiseptic and hemostatic agents public in Hatay/Tukey.
METHODS: Thirty rats were divided into three groups equally and blood samples were taken from all rats for preoperative hemoglobin (Hb) measurements. Then, the standard liver resection model was applied to all rats. Sponge for the first rat group, Ankaferd Blood Stopper® Trend-Tech for the second rat group and IvCbp plant extract mixture for the third group were applied to resection areas for 3 minutes. Liver samples of all rats were evaluated in terms of inflammation and necrosis intensity on the 5th post-operative day.
RESULTS: Post-operative Hb values were found as 11.0±1.1 g/dL in the sponge group, 11.9±2.0 g/dL in the Ankaferd group, and 14.1±1.2 g/dL in the IvCbp herb mixture group (p<0.001). In the histopathological examination, less necrosis was observed in the herb mixture group compared to the sponge and Ankaferd groups (p=0.001). In addition, no statistically significant necrosis difference was observed between sponge and Ankaferd groups. While less inflammation was observed in the herb mixture group compared to the other groups, Ankaferd group had the highest inflammation score (p<0.001).
CONCLUSION: IvCbp herb mixture extract group provide effective hemostatic control, caused less Hb decrease and resulted in less inflammation and necrosis compared to Ankaferd and sponge groups in a rat liver resection model.

Keywords: Bleeding, Capsella bursa-pastoris; ethnomedicine; hemostasis; Inula viscosa; liver surgery.

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Karaciðer parankim kanamasý oluþturulan sýçanlarda Inula viscosa ve Capsella bursa- pastoris ekstre karýþýmýnýn hemostatik etkisi

Ozan Utku Öztürk¹, Mustafa Ugur¹, Yelda Güzel², Mehmet Ali Öztürk³, Didar Gürsoy⁴, Serdar Doðan⁵, Muhyittin Temiz^1
1Hatay Mustafa Kemal Üniversitesi Týp Fakültesi, Genel Cerrahi Anabilim Dalý, Hatay
²Hatay Mustafa Kemal Üniversitesi Fen Edebiyat Fakültesi, Biyoloji Anabilim Dalý, Hatay
³Freiburg Üniversitesi, Biyoloji Enstitüsi, Freiburg-Almanya
⁴Hatay Mustafa Kemal Üniversitesi Týp Fakültesi, Patoloji Anabilim Dalý, Hatay
⁵Hatay Mustafa Kemal Üniversitesi Týp Fakültesi, Biyokimya Anabilim Dalý, Hatay

AMAÇ: Karaciðer cerrahisinde etkili bir kanama kontrolünün saðlanamamasý ve transfüzyona baðlý problemler ameliyat sonrasý mortalite ve morbiditenin en önemli nedenleridir. Bu amaçla topikal hemostatik ajanlarý da içeren birçok kanama durdurma yöntemi uygulanmaktadýr. Bu çalýþmada, sýçanlar üzerinde oluþturulan karaciðer laserasyon modeli üzerinde Hatay’da halk arasýnda geleneksel olarak kanama durdurucu ve antiseptik olarak kullanýlan Inula viscosa ve Capsella bursa-pastoris bitkilerinin karýþýmýnýn kanama durdurucu özelliðinin araþtýrmasý amaçlandý.
GEREÇ VE YÖNTEM: Çalýþmada 30 sýçan, 10’arlý üç gruba ayrýldý ve bütün sýçanlardan ameliyat öncesi hemoglobin ölçümü için kan alýndý. Daha sonra sýçanlara standart karaciðer rezeksiyon modeli uygulandý. Rezeksiyon bölgesine 1. grupta spanç, 2. grupta Ankaferd ve 3. grupta Inula viscosa ve Capsella bursa-pastoris bitkilerinin ekstre karýþýmý üç dakika süreyle uygulandý. Ameliyat sonrasý beþinci gün bütün sýçanlarýn karaciðer örnekleri enflamasyon ve nekroz yoðunluðu açýsýndan deðerlendirildi.
BULGULAR: Ameliyat sonrasý Hb deðerleri spanç grubunda 11.0±1.1 g/dL, Ankaferd grubunda 11.9±2.0 g/dL, Ýnula grubunda 14.1±1.2 g/dL olarak saptanmýþtýr (p<0.001). Yapýlan histopatolojik incelemede Ýnula grubunda diðer gruplara göre daha az nekroz gözlenmiþ (p=0.001), spanç ve Ankaferd gruplarý arasýnda istatistiksel olarak anlamlý bir fark bulunamamýþtýr. Ýnula grubunda diðer gruplara göre daha az enflamasyon izlenirken Ankaferd grubunda diðer gruplara göre daha fazla enflamasyon izlenmiþtir (p<0.001).
TARTIÞMA: Bu çalýþmada oluþturulan sýçan karaciðer rezeksiyon modelinde Ýnula viscosa ve Capsella bursa-pastoris ekstre karýþýmýnýn Ankaferd ve spanç grubuna kýyasla daha az hemoglobin düþüþüne neden olduðu ve diðer gruplara kýyasla daha az enflamasyon ve nekroz oluþturduðu bulundu.

Anahtar Kelimeler: Capsella bursa-pastoris, hemostaz; Ýnula viscosa; kanama; karaciðer.

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