COMPARATIVE SAFETY AND EFFICACY OF HEMOSTATIC AGENTS IN A RABBIT LIVER INJURY MODEL

Abstract

Liver trauma represents a major clinical concern due to the organ’s rich vascularity and high bleeding risk. This study evaluated and compared the safety, efficacy, and tissue responses of three hemostatic agents—Tranexamic Acid (TA), Oxidized Regenerated Cellulose (ORC), and Surgiflo—in a controlled rabbit liver injury model. Forty-eight rabbits were randomly assigned to four groups: Control, TA, ORC, and Surgiflo. Parameters assessed included bleeding time, blood loss, clot stability, systemic and local inflammatory responses, ultrasonographic changes, liver enzyme levels, fibrinolytic activity, histopathology, and survival rates. Surgiflo achieved the most rapid hemostasis (mean 50 ± 8 sec), lowest blood loss (2.1 ± 0.32 mL), and highest survival rate (92%). TA provided superior clot stability (85%) and minimal inflammatory infiltration, indicating favorable tissue compatibility. ORC demonstrated moderate hemostatic efficacy but was associated with higher inflammatory scores and focal fibrosis. D-dimer concentrations were lowest in Surgiflo-treated animals, suggesting effective fibrinolysis suppression. Overall, Surgiflo emerged as the most rapid and effective hemostatic agent, while TA offered strong clot stability with minimal tissue inflammation. ORC, though effective in reducing bleeding, showed higher adverse tissue responses. These findings provide important insights for evidence-based selection of hemostatic agents in managing hepatic bleeding in both veterinary and clinical practice.