Introduction and Objectives
We evaluated the efficacy of a folkloric medicinal plant extract (Ankaferd Blood Stopper® [ABS]) compared with oxidized cellulose (Surgicel®) in an acute renal injury model. ABS is a mixture of 5 plants that has historically been used in Turkish traditional medicine. It has been approved by the Ministry of Health to manage external hemorrhage and dental surgery bleeding in Turkey.
Material and Methods
Twenty-two Wistar albino rats underwent partial nephrectomy after intravenous heparin anticoagulation (2000 units per kg). The cut surface received 1 of 3 therapies, namely no treatment, Surgicel® (Johnson & Johnson, New Brunswick, New Jersey, USA) or ABS (Trend Teknoloji Ìlaç A.Ş., Istanbul, Turkey). Blood pressure was continually monitored. Survival time, total blood loss and mean arterial pressure (MAP) were recorded for 60 min or until death. Rats which were alive (MAP > 20 mmHg) at the end of 60 min were sacrificed with blood withdrawal from catheters.
Results
All animals that received no treatment died within 60 min of follow up period. One out of 7 in Surgicel group, and 5 out of 7 animals in ABS group, survived. Mean survival times for Surgicel and ABS groups were 42.7 and 53.4 min, respectively (Table 1). Rats in the ABS and Surgicel groups survived significantly longer than rats in the control group (p < 0.05). There were no significant differences between the ABS and the Surgicel groups in survival (p = 0.128).
Table 1:Comparability of groups treated and treatment results in ABS, Surgicel and control groups
| p values | ||||||
|---|---|---|---|---|---|---|
| Control group mean±SD (n=8) | Surgicel group mean±SD (n=7) | ABS group mean±SD (n=7) | Control vs Surgicel | Control vs ABS | Surgicel vs ABS | |
| Weight (gr) | 392.4±34.3 | 357.3±26.4 | 368.4±21.4 | 0.189 | 0.232 | 0.902 |
| Excised Kidney (mg) | 437.5±5.1 | 414.3±3.78 | 428.6±7.55 | 0.463 | 0.955 | 0.620 |
| TRW% excised | 33.3±3.4 | 34.1±4.4 | 32.4±3.3 | 0.867 | 0.694 | 0.535 |
| BW% excised | 0.10±0.01 | 0.11±0.01 | 0.11±0.02 | 0.779 | 0.694 | 0.805 |
| Ìnitial MAP (mmHg) | 125.12±8.79 | 130.00±10.04 | 129.71±5.49 | 0.536 | 0.281 | 0.902 |
| Final MAP (mmHg) | 0 | 9.8±26.07 | 33.28±31.25 | 0.694 | 0.021 | 0.097 |
| Net Blood Loss (mg) | 6.41±1.32 | 6.45±1.29 | 5.54±1.49 | 0.955 | 0.397 | 0.383 |
| Net Blood Loss (mg/kg) | 16.42±3.46 | 18.13±3.63 | 15.04±4.11 | 0.397 | 0.694 | 0.097 |
| Survival time (minutes) | 14.25±10.45 | 42.71±11.54 | 53.43±13.11 | 0.002 | 0.001 | 0.128 |
| Sixty-minute-survival/ | 0/8 (0%) | 1/ 7 (14.3%) | 5/7 (71.4%) | 0.467 | 0.007 | 0.051 |
| Total (n)-(%) | ||||||
* Mann-Whitney U test ABS: Ankaferd Blood Stopper® MAP: Mean arterial pressure TRW % excised: The percentage of excised kidney portion to the total renal weight BW % excised: The percentage of excised kidney portion to the total body weight
Conclusions
ABS is as effective as Surgicel in achieving hemostasis and lengthening survival time following partial renal excision in an experimental rat model.
Article info
Identification
Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
