Evaluation of the effects of different hemostatic agent applications on mental nerve.

ABSTRACT

PURPOSE: Evaluating the effect of ABS (Ankaferd Blood Stopper®), Tranexamic Acid (Transamin®) and Thrombin-Containing Hemostatic Matrix (Floseal®) on the mental nerve of rats by using histopathologic and immunohistochemical analyses. MATERIALS AND METHODS: 40 Wistar Albino rats were used. Rats were randomly selected into 4 groups as Control (G1), ABS (G2), Tranexamic Acid (G3) and Thrombin-Containing Hemostatic Matrix (G4). In the control group G1, the left mental nerve was exposed and 0.3 ml of sterile saline was applied for 5 min, then closed with suture. In the other three groups, the left mental nerve was exposed and 0.3 ml ABS, Tranexamic Acid and Floseal was applied to groups, respectively. After 5 min, wounds were closed with suture. Immunohistochemical and histopathologic examinations were performed on mental nerves after 28 days. RESULTS: The total histopathologic and immunohistochemical semiquantitative scores were significantly higher in ABS (G2) compared to Control (G1), Tranexamic Acid (G3) and Thrombin-Containing Hemostatic Matrix (G4) (P < 0.05). Myelin thickness were significantly lower in G2 compared to G1, G2 and G3 (P < 0.05). G3 has the most reliable results compared to G2 and G4 (P < 0.05). CONCLUSION: The study results suggest that ABS has neurotoxic effects and should not be used close to the nerve, and thrombin-containing hemostatic matrix should be used carefully. Tranexamic acid, on the other hand, was found to be the most reliable hemostatic agent for use in close proximity to neural tissues. Further studies are required to determine the efficacy of the hemostatic agents on peripheral nerve degeneration.