Year 2024 Vol. 32 No 1

SCIENTIFIC PUBLICATIONS

A.A. KINZERSKIY, M.S. KORZHUK, V.T. DOLGIKH, T.S. SOLOV’YOVA

THE MODELING OF SEVERE CLOSED BLUNT LIVER TRAUMA

Omsk City Emergency Hospital 1 1, Omsk, the Russian Federation,
NMRC of Oncology named after N.N.Petrov of MoH of Russia 2, St. Petersburg,
Military Medical Academy named after S.M.Kirov 3, of MoD of Russia,
Federal Scientific Center of Reanimatology and Rehabilitology
of Russian Academy of Science 4, Moscow,
St. Petersburg Clinic Hospital of Russian Academy of Science 5, St. Petersburg, Russian Federation

Objective. The determination of the necessary damage energy and anatomical landmarks for modeling severe blunt closed liver injury by the «impact» mechanism using developed device.
Material and Methods. The experiments were carried out on male Wistar rats (n=42) weighing 379 ±23 g. It was necessary to get a liver injury of III-IV according to J.M. Cox and J.E. Kalns: ruptures from 2 to 3.5 cm and more . At the first stage, the optimal height of the fall (mass 425 g) in the epigastrium at the level of the base of the xiphoid processus was determined, at which liver damage of more than 2 cm is achieved without damage of the inferior vena cava. The rats were randomized into 3 groups according to the height of the load drop: I-I (n=4) – height 40 cm, I-II (n=4) – 20 cm, I-III (n=5) – 28 cm. At the second stage, the search for anatomical landmarks for the impact was carried out to avoid damage to other organs of the abdominal and thoracic cavity. 4 zones were selected on the anterior abdominal wall of the animal to focus the impact: in the left hypochondrium (group II-I, n=5), in the right hypochondrium 5 mm below and 10 mm to the right of the tip of the xiphoid process (group II-II, n=5), in the epigastrium at the level of the tip of the xiphoid process (Group II-III, n=5), 5 mm to the right and above the tip of the xiphoid process (group II-IV, n=14). A device developed by the authors implementing the «impact» mechanism was used to inflict injury. Considering that the number of animals in the groups is small, a median with a 95% confidence interval (CI) was used for the average value of the liver rupture length.
Results. The height of the load drop of 40 cm turned out to be excessive, since the inferior vena cava was injured, and the height of 20 cm was insufficient, since the length of the liver rupture did not reach 2 cm in length. The optimal height was 28 cm for a load of 425 g – the impact energy was 1.17 joules. Only in group II-IV, focusing the impact 5 mm above and to the right of the tip of the xiphoid process led to extensive damage to the parenchyma of the right and left median lobe, upper and lower caudate lobe of the liver with a median [95% CI] rupture length of 5.5 [2.49;7.8] cm, without injuries of the thoracic and abdominal organs, and also the inferior vena cava.
Conclusion. The developed device with selected landmarks and impact energy allows it to be used as experimental model of a closed liver injury. Stable achieving of homogeneous liver injuries III-IV is becoming.

Keywords: liver trauma, animal trauma model, Wistar rats
p. 39-45 of the original issue
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Address for correspondence:
644074, Russian Federation,
Omsk, Komarov Ave. 17/3, 96,
BHIOR «City Clinical Emergency Hospital No. 1»,
Surgical Department,
tel.: +7-913-151-39-89,
e-mail: kinzerskij@mail.ru
Kinzerskiy Alexander A.
Information about the authors:
Kinzerskiy Alexander A., Surgeon of the Surgical Department of the BHIOR «City Clinical Emergency Hospital No. 1»,
http://orcid.org/0000-0001-5749-1873
Korzhuk Mikhail S., MD, Professor, Lecturer in the Department of Naval Surgery of the Federal State Budgetary Educational Institution of Higher Education «Military Medical Academy named after. CM. Kirov» of the Ministry of Defense of the Russian Federation, Researcher at the Scientific Laboratory of Cancer Chemoprevention and Oncopharmacology of the Federal State Budgetary Institution «National Medical Research Center of Oncology named after. N.N. Petrov» of the Ministry of Health of Russia of the Russian Federation, St. Petersburg, Russian Federation.
http://orcid.org/0000-0002-4579-2027
Dolgikh Vladimir T., MD, Professor, Honored Scientist of the Russian Federation, Chief Researcher of the Research Institute of General Reanimatology named after. V.A. Negovsky Federal State Budgetary Institution «Federal Scientific and Clinical Center of Reanimatology and Rehabilitation», Moscow, Russian Federation.
http://orcid.org/0000-0001-9034-4912
Solovyova Tatyana S. Pathologist of the St. Petersburg Clinical Hospital of the Russian Academy of Sciences, г. Санкт-Петербург, Российская Федерация.
http://orcid.org/0009-0005-2672-276X
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