Effect of a Chitosan-Based Hemostatic Dressing on Blood Loss and Survival in a Model of Severe Venous Hemorrhage and Hepatic Injury in Swine

McCarthy, Simon J.; Gregory, Kenton W.; Harris, Richard; Cardenas, Luis; McManus, Albert T.; Goodwin, Cleon W.

doi:10.1097/00005373-200301000-00023

Cited by 258 publications

(182 citation statements)

References 39 publications

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“…A large effect size was determined for this experiment based upon previous work by Alam and Pusateri [21,27]. Using G-Power 3.00, an effect size of 0.6, a power of 0.80, and an a of 0.05, it was determined that a sample size of five swine per group was needed for this study.…”

Section: Resultsmentioning

confidence: 99%

The Effects of BleedArrest, Celox, and TraumaDex on Hemorrhage Control in a Porcine Model

Gegel

Burgert

Cooley

et al. 2010

Journal of Surgical Research

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Background. Hemorrhage is the second leading cause of death in civilian trauma and the leading cause of preventable death in military trauma. The purpose of this study was to examine the effectiveness of three hemostatic agents: BleedArrest, TraumaDex, and Celox.Materials and Methods. This was a prospective, experimental study using male Yorkshire swine. The pigs (n [ 5 per group) were randomly assigned to one of the following: BleedArrest, TraumaDex, Celox, or control. To simulate a trauma injury, the investigators generated a complex groin injury with transection of the femoral artery and vein in all pigs. After 1 min of uncontrolled hemorrhage, one of the hemostatic agents was poured into the wound, followed by standard wound packing. The control group underwent the same procedures with the exception of the hemostatic agents. In all groups, 5 min of direct manual pressure was applied to the wound followed by a standard pressure dressing. After 30 min, dressings were removed, and the amount of bleeding was determined.Results. There were significant differences between the BleedArrest (mean [ 21.2, SD ± 36.6 mL) TraumaDex (mean [ 68, SD ± 103.5 mL) and Celox (mean [ 18.l6, SD ± 41.6 mL) groups compared with Control group (mean [ 230, SD ± 154 mL) (P < 0.05). However, there were no statistically significant difference between BleedArrest, TraumaDex, and Celox groups (P [ 0.478).Conclusions. BleedArrest, Celox, and TraumaDex were statistically and clinically superior at controlling hemorrhage compared with the standard pressure dressing in the control group. Published by Elsevier Inc.

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Section: Resultsmentioning

confidence: 99%

The Effects of BleedArrest, Celox, and TraumaDex on Hemorrhage Control in a Porcine Model

Gegel

Burgert

Cooley

et al. 2010

Journal of Surgical Research

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“…An earlier chitosanbased dressing has also been previously shown to be effective in an alternate model of hepatic trauma in nonheparinised swine. 10 The addition of a significant amount of heparin to this model makes it more challenging, but more useful given that patients who have had major liver trauma are liable to be coagulopathic. In spite of this, haemostasis was usually achieved, supporting both the in vitro laboratory evidence where clotting occurs in fully anti-coagulated blood and our own previous experience.…”

Section: Discussionmentioning

confidence: 99%

“…8 The deployment of chitosan-based products in the military setting is supported by in vivo experimental work showing 100% effectiveness in an industry standard model of lethal groin haemorrhage in swine, 9 and improved outcome in a model of hepatic injury in swine. 10 We have previously shown that Omni-Stat ® (MedTrade Products Ltd, Electra House, Electra Way, Crewe Business Park, Crewe CW1 6GL, UK), a proprietary preparation of chitosan granules, has the ability to provide reliable haemostasis in a moderately heparinised modification of an industry standard model of femoral artery haemorrhage (manuscript submitted). We are also aware of anecdotal reports of successful haemostasis using chitosan granules and gauzes in the management of hepatic injuries in the current conflict in Afghanistan.…”

mentioning

confidence: 99%

Chitosan arrests bleeding in major hepatic injuries with clotting dysfunction: an in vivo experimental study in a model of hepatic injury in the presence of moderate systemic heparinisation

Millner

Lockhart

Marr³

2010

annals

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INTRODUCTION The purpose of this study was to explore the effectiveness of two chitosan formulations, Omni-Stat ® granules and Celox Gauze ® , in a model of major hepatic injury in the presence of clotting dysfunction. MATERIALS AND METHODS Major hepatic injuries in moderately heparinised swine were treated with either Omni-Stat ® granules or Celox Gauze ® as compared to control plain gauze.RESULTS Plain gauze control failed to stop the bleeding in 13 of 14 attempts. Omni-Stat ® arrested the bleeding in 18 of 18 attempts, providing it was in contact with the bleeding surface. Celox Gauze ® arrested bleeding in 5 out of 6 attempts initially, and with further pressure in the sixth. CONCLUSIONS The results support the evidence that chitosan-derived products act independently of classical clotting pathways and should be effective in patients who suffer major liver injury even in the presence of clotting dysfunctions.

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“…[1][2][3][4] In the case of cardiac surgery, for example, bleeding may result from several aspects inherent to cardiac procedures, including the placement of cardiac suture lines in great vessels or chambers of the heart, as well as the creation of high-pressure anastomoses. 5 Therefore, effective and rapid hemostasis is critical to optimize surgical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Nanocomplexation of thrombin with cationic amylose derivative for improved stability and hemostatic efficacy

Zhuang¹,

Li²,

Pang³

et al. 2015

IJN

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As a topical hemostatic agent, thrombin has wide application for many surgical treatments. However, native thrombin always suffers from its physical and chemical instabilities. In this work, a nanocomplexation strategy was developed for modifying the stability and hemostatic efficacy of thrombin, in which a water-soluble cationic amylose derivative containing poly( l -lysine) dendrons was prepared by a click reaction and then used to complex thrombin in an aqueous system. For resultant thrombin nanocomplexes, their morphology and particle size distribution were investigated. Their stabilities were studied in terms of activity retention percentages under different storage time, pH values, and illumination time. In addition, their ability to achieve in vitro fibrinogen and blood coagulation were evaluated. Via a rat hepatic hemorrhage model and a rat iliac artery hemorrhage model, these thrombin nanocomplexes were confirmed to have good tissue biocompatibility and in vivo hemostatic effectiveness.

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Effect of a Chitosan-Based Hemostatic Dressing on Blood Loss and Survival in a Model of Severe Venous Hemorrhage and Hepatic Injury in Swine

Abstract: A chitosan dressing reduced hemorrhage and improved survival after severe liver injury in swine. Further studies are warranted.

Cited by 258 publications

References 39 publications

The Effects of BleedArrest, Celox, and TraumaDex on Hemorrhage Control in a Porcine Model

The Effects of BleedArrest, Celox, and TraumaDex on Hemorrhage Control in a Porcine Model

Chitosan arrests bleeding in major hepatic injuries with clotting dysfunction: an in vivo experimental study in a model of hepatic injury in the presence of moderate systemic heparinisation

Nanocomplexation of thrombin with cationic amylose derivative for improved stability and hemostatic efficacy

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Effect of a Chitosan-Based Hemostatic Dressing on Blood Loss and Survival in a Model of Severe Venous Hemorrhage and Hepatic Injury in Swine

Abstract: A chitosan dressing reduced hemorrhage and improved survival after severe liver injury in swine. Further studies are warranted.

Cited by 258 publications

References 39 publications

The Effects of BleedArrest, Celox, and TraumaDex on Hemorrhage Control in a Porcine Model

The Effects of BleedArrest, Celox, and TraumaDex on Hemorrhage Control in a Porcine Model

Chitosan arrests bleeding in major hepatic injuries with clotting dysfunction: an in vivo experimental study in a model of hepatic injury in the presence of moderate systemic heparinisation

Nanocomplexation of thrombin with cationic amylose derivative for improved stability and&nbsp;hemostatic efficacy

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Product

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Nanocomplexation of thrombin with cationic amylose derivative for improved stability and hemostatic efficacy