title: Effect of Fibrin Packing on Managing Hepatic Hemorrhage and Liver Wound Healing in a Model of Liver Stab Wound in Rat.
abstract: OBJECTIVE
  To evaluate the effect of fibrin perihepatic packing on controlling liver hemorrhage and liver wound healing.
  
  
  METHODS
  In this animal experimental study, 20 adult male Sprague Dawley rats, weighing 200-220 g, were included. Stab wound injury was created by number 15 scalpel, so that bilateral liver capsules and liver tissue were cut, and acute bleeding was accrued. The animals were divided into 2 study groups: control (with a primary gauze packing treatment) and test group (with fibrin packing treatment). Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total serum bilirubin (TSB) levels were measured as a liver function test during the treatment period. Blood loss was calculated for estimation of hepatic hemorrhage during surgery. After four weeks, the liver wound repair was evaluated by sampling and Hematoxylin and Eosin staining (H&E).
  
  
  RESULTS
  In the test group, all of animals were alive (mortality rate= 0%). Significantly, ALT and AST levels were raised after surgery, followed by a decrease ALT (p=0.783) and AST (p=0.947) to the normal level during 4 days. Estimated blood loss was 2.89 ± 0.73 mL (about 19.65% of estimated blood volume). Hematocrit levels returned to the normal level (p=0.109) after 48 hours. In the control group, the mortality rate was 50% during 12h after surgery. ALT (p=0.773) and AST (p=0.853) were decreased to normal level during 6 days, and estimated blood loss was 4.98 ± 0.77 mL (about 32.98% of estimated blood volume) in the remaining animals. Moreover, hematocrit levels returned to the normal level (p=0.432) after 72 hours. Estimated blood loss in the test group was significantly less than control group (p<0.001). Total serum bilirubin levels were not significantly different from the normal level, before and after surgery in both groups. Histopathology sections from the post-hepatectomy specimens showed that the site of the previous incision was completely repaired, and a dense fibrous septum was observed in both groups.
  
  
  CONCLUSIONS
  The fibrin dressing was effective in preventing blood loss and saving lives after a liver stab injury and major internal bleeding in the animal model of rat.
authors.affiliation: Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mehrzad
authors.initials: M
authors.lastname: Banihashemi
authors.affiliation: Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Azam
authors.initials: A
authors.lastname: Safari
authors.affiliation: Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Navid
authors.initials: N
authors.lastname: Nezafat
authors.affiliation: Department of Pathobiology, Saadati Pathobiology Laboratory, Shiraz, Iran.
authors.forename: Mahmoodreza
authors.initials: M
authors.lastname: Tahamtan
authors.affiliation: Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Manica
authors.initials: M
authors.lastname: Negahdaripour
authors.affiliation: Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Department of pathology, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Negar
authors.initials: N
authors.lastname: Azarpira
authors.affiliation: Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Younes
authors.initials: Y
authors.lastname: Ghasemi
keywords: Fibrin packing; Hemorrhage; Liver; Penetrating injury; Trauma; Wound healing