OBJECTIVETo explore the efficacy of injectable gelatin matrix as a hemostatic agent for treatment of grade III-IV hepatic trauma to a canine model with contrast-enhanced ultrasound (CEUS) guidance.

METHODSTwenty-seven healthy adult dogs underwent celiotomy in induce grade III-IV hepatic trauma in the left lateral lobe of the liver. The dogs were then randomized into 3 groups, namely the treatment group in which the injectable hemostat was percutaneously injected into the injury site under CEUS guidance, and the positive and negative control groups with thrombin solution and normal saline treatment, respectively. Intra-abdominal blood loss within 30 min postoperatively, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) 7 days postoperatively were compared among the groups. Follow-up CEUS was performed in each animal 7 days after the operation.

RESULTSThe mean blood loss was 47.69 ml in the treatment group, significantly less than that in the positive control group (81.77 ml, P/0.01) and negative control group (110.35 ml, P<0.01). The treatment group had also significantly lower ALT and AST levels than the two control groups (ALT: 49.37, 62.81, and 82.83 U/L, respectively, P<0.05; AST: 48.32, 67.16, and 82.54 U/L, respectively, P<0.05). In the treatment group, CEUS did not detect hepatic lesions or ascites as found in the two control groups, and the perfusion of the liver was homogeneous.

CONCLUSIONThe injectable hemostat injected under the guidance of CEUS can effectively control grade III-IV hepatic hemorrhage in the canine model and show strong effects of stopping bleeding and promoting wound healing.