Comparison of 10 hemostatic dressings in a groin puncture model in swine

Arnaud, Françoise; Teranishi, Kohsuke; Tomori, Toshiki; Carr, Walter; McCarron, Richard M.

doi:10.1016/j.jvs.2009.06.010

Cited by 71 publications

(59 citation statements)

References 23 publications

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“…Two injury models [6][7][8][9][10][11][12][13], a full femoral transection (including artery and vein) and a femoral artery puncture yield massive blood loss in the early phase of bleeding and severe hemorrhagic shock consequences if untreated. Our previous results indicated that dressing efficacy outcomes were different across these two injury models [1,2]. There was more post-treatment bleeding after the compensatory phase in the puncture injury model than the transection.…”

Section: Introductionmentioning

confidence: 99%

“…In an effort for better hemostatic control in noncompressible areas such as the neck or the groin where tourniquets cannot be used, a variety of highly effective hemostatic dressings have become available and can be selected according to various qualities like their physical nature. In a previous series of experiments comparing 10 hemostatic dressing products to compressed gauze (as the standard of care) [1,2], three products, X-Sponge (Z-Medica, Wallingford, CT), a synthetic gauze coated with kaolin; Woundstat (TraumaCure, Bethesda, MD), a smectite/polymer granular product; and Celox (Sam Medical Products, Newport, OR), a chitosan-based product, were found to be the most effective dressings for survival, blood loss, and bleeding control among those tested. A key observation in those experiments was that the fabric-based products (e.g., X-Sponge) were similar in form to standard gauze and could be relatively easily removed, leaving a clean wound, ready for surgical repair.…”

Section: Introductionmentioning

confidence: 99%

“…We report on the evaluation of two relatively new fabric-like hemostatic dressings in these two surgical models, developed to simulate injuries from the battlefield [1,2] and to address various levels of vascular injury. The objective of this study is to evaluate the efficacy of CBG and TMS.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Combat Gauze and TraumaStat in Two Severe Groin Injury Models

Arnaud

Teranishi

Okada

et al. 2011

Journal of Surgical Research

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Background. Fabric-like hemostatic dressings offer promise for hemorrhage control in noncompressible areas, especially given their similarity in form to standard gauze currently in use. Recently, two such products, Combat Gauze (CBG) and TraumaStat (TMS), were introduced. Their performance is evaluated in two vascular injury models.Materials and Methods. The dressings were evaluated in anesthetized Yorkshire pigs, hemorrhaged by full transection of the femoral vasculature with 2 min free bleeding period (CBG [ 6, TMS [ 6) or by 4 mm femoral arterial puncture with 45 s free bleeding period (CBG [ 8, TMS [ 8). After injury, dressings were applied, followed by 5 min of manual compression and then 500 mL resuscitation fluid infused over 30 min. Vital signs, blood pressure, and blood loss were recorded throughout the 3-h experiment. Bleeding control was the primary outcome.Results. All animals had similar pretreatment mean arterial pressure (MAP) (w36.5 mmHg); pretreatment blood loss following injury was similar for both dressing groups in the two models [24% ± 8% estimated blood volume (EBV) 2 min after transection and 17% ± 4% EBV 45 s after puncture. Incidence of post-treatment bleeding, primarily occurring after release of manual compression or restoration of blood pressure, was more frequent in the puncture model (17% with both CBG and TMS) than the transection model (57% with CBG versus 75% with TMS). Post-treatment blood loss not controlled by the dressing was 19% ± 22% and 31% ± 17% EBV, for CBG and TMS, respectively. Survival rate was 100% for both dressings in the transection model, and was 88% for CBG and 50% for TMS in the puncture model.Conclusions. These findings indicated that CBG and TMS were similarly effective in improving hemostasis. These two fabric-like dressings showed easy application and removal, leaving a clean wound for surgical repair. Ó 2011 Elsevier Inc. All rights reserved.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of Combat Gauze and TraumaStat in Two Severe Groin Injury Models

Arnaud

Teranishi

Okada

et al. 2011

Journal of Surgical Research

Self Cite

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“…The form of a hemostatic agent impacts the removability of dressing residues from the wound as well as the potentially harmful effects (Arnaud et al 2009, Clay et al 2010, Kheirabadi et al 2010. Herein, we did not observe any differences in the macroscopic or microscopic changes in the internal organs among the groups examined.…”

Section: Discussionmentioning

confidence: 48%

“…The newest agents, which consist of gauze dressings impregnated with kaolin and chitosan, are more effective and simple to use, and have a low risk of tissue injury and thromboemboli formation (Kheirabadi et al 2010, Johnson et al 2014. The majority of studies on the effectiveness of hemostatic agents using animal models have examined the influence of a short-term dressing application that was no longer than a few hours (Arnaud et al 2009, Kheirabadi et al 2010, Littlejohn et al 2011, Gegel et al 2012). There are no previously published studies on the consequences of the long-term application of hemostatic dressing, which is occasionally necessary on the battlefield, especially when the individual must be transported hundreds of kilometers to a medical facility.…”

Section: Discussionmentioning

confidence: 99%

Safety of the long-term application of QuikClot Combat Gauze, ChitoGauze PRO and Celox Gauze in a femoral artery injury model in swine – a preliminary study

Otrocka-Domagała

Jastrzębski

Adamiak

et al. 2016

Polish Journal of Veterinary Sciences

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The purpose of this study was to examine the safety of the long-term application of QuikClot Combat Gauze, ChitoGauze PRO and Celox Gauze using a swine model. The study was conducted on nine pigs weighing approximately 30 kg, which were randomly divided into three groups. Under deep anesthesia, the pigs underwent complete transverse cutting of the femoral artery in the groin region. Hemostatic dressings were left in the wound for 24 hours. The animals were euthanized 24 hours after dressing application. In each group, macroscopic and microscopic severe changes and shock symptoms were observed in the lungs, liver, kidneys and heart. Fibrino-gaseous embolic material was found in the pulmonary artery of each group and in the lung vessels of the animals from the ChitoGauze PRO and Celox Gauze groups. In conclusion, the long-term application of the evaluated hemostatic dressings has the risk of coagulopathy and reaching the progressive stage of shock. The residues from the hemostatic dressings can ingress into the systemic circulation, thereby increasing the risk of embolus formation. Because of these harmful effects, the evaluated hemostatic dressings are not appropriate for long-term use. Future studies are needed on the consequences of the long-term application of these hemostatic agents.

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Superhydrophobic/Superhydrophilic Janus Fabrics Reducing Blood Loss

Zhu

Zhao

et al. 2018

Adv Healthcare Materials

106

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Hemostatic fabrics are most commonly used in baseline emergency treatment; however, the unnecessary blood loss due to the excessive blood absorption by traditional superhydrophilic fabrics is overlooked. Herein, for the first time, superhydrophobic/superhydrophilic Janus fabrics (superhydrophobic on one side and superhydrophilic on the other) are proposed: the superhydrophilic part absorbs water in the blood to expedite the clotting while the superhydrophobic part prevents blood from further permeating. Compared with the common counterparts, effective bleeding control with reducing blood loss more than 50% can be achieved while the breathability largely remain by using Janus fabrics. The proposed prototypes can even prolong the survival time in the rat model with serious bleeding. This strategy for reducing blood loss via simply tuning wettability is promising for the practical applications.

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Comparison of 10 hemostatic dressings in a groin puncture model in swine

Abstract: The findings indicated that the efficacy of Woundstat, Celox, X-Sponge, and ACS+ were similar and superior in improving survival, hemostasis, and maintenance of mean arterial pressure in an actively bleeding wound caused in this severe vascular injury model.

Cited by 71 publications

References 23 publications

Comparison of Combat Gauze and TraumaStat in Two Severe Groin Injury Models

Comparison of Combat Gauze and TraumaStat in Two Severe Groin Injury Models

Safety of the long-term application of QuikClot Combat Gauze, ChitoGauze PRO and Celox Gauze in a femoral artery injury model in swine – a preliminary study

Superhydrophobic/Superhydrophilic Janus Fabrics Reducing Blood Loss

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