Morphologic Features of the Vascular Wall in the Reconstruction Zone on the Main Arteries Using a Topical Hemostatic Solution

INTRODUCTION: In the course of our previous study on the use of Hemoblock hemostatic agent, positive results were obtained, characterizing it as an effective and safe means when used in reconstructive surgeries on the main arteries. However, of interest is further investigation of histopathological changes in tissues of the reconstruction zone in operations using Hemoblock hemostatic solution. AIM: To study the morphological features of the vascular wall when using Hemoblock hemostatic solution to achieve hemostasis in reconstructive operations on the aorta with use of various synthetic materials in an experiment. METHODS AND MATERIALS: The study was conducted on tissue material obtained from 80 outbred cats, which were divided into 4 equal group by blind randomization: 2 experimental groups and 2 control groups. The obtained surgical material was fixed for at least 24 hours in 10% buffered formalin solution in proportion of at least 20 volumes of formalin to 1 volume of the material. The finished histological preparations were stained with hematoxylin and eosin, and also with a mixture of picric acid and fuchsine according to van Gieson. The preparations were studied and photographed using a Leica DM 2000 microscope, for morphometry ImageJ program was used. Morphometry of the vessel wall was performed in each preparation in three places: along the edges of the implant and in the center. Statistical processing of the obtained data was conducted in Microsoft Excel 2016 program. RESULTS: In comparing the mean thickness of the vessel wall at the site of contact with the Dacron prosthesis, hypertrophy of the outer wall was reliably less expressed (p < 0.05) when using Hemoblock, with no reliable differences in the thickness of the inner and middle walls. When using a polytetrafluoroethylene (PTFE) prosthesis, the mean thickness of the inner, middle and outer walls was less in the group with Hemoblock than in the group without it, with reliable differences (p < 0.05). It is interesting that on the intact side of contact of the vessel with PTFE and Hemoblock, the middle wall was significantly thicker than in a similar case without the use of Hemoblock. The type of histopathological changes confirms the presence of productive inflammation around the foreign body in all study groups, however, in the groups with Hemoblock, the inflammation was less expressed that was also evidenced by less hypertrophy of the vessel wall at the sites of contact with the implant. CONCLUSION: The constituent components of morphological alterations are similar in all study groups, productive inflammation around the foreign object is observed in all study groups, but application of Hemoblock diminishes inflammatory reaction and the formation of the connective tissue mainly in the outer vessel wall. The data about the character of changes in the vessel wall at the morphological level, obtained in the study, correlate with the results described in the previous article, therefore, the effectiveness of Hemoblock hemostatic agent has not only clinical, but also histological confirmation.