Hemostatic Dressings for the First Responder: A Review

Neuffer, Marcus; McDivitt, Jonathan D.; Rose, David J.; King, Kelly A.; Cloonan, Clifford C.; Vayer, Joshua S.

doi:10.7205/milmed.169.9.716

Cited by 130 publications

(63 citation statements)

References 2 publications

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“…HemCon bandage is a compressed chitosan acetate dressing that was developed as a hemostatic agent [10]. It is used to stem blood flow, especially flow from severely bleeding wounds [11]. Previously the application of continuous pressure with gauze bandage was the preferred primary intervention technique used to stem severe bleeding from wounds.…”

Section: Introductionmentioning

confidence: 99%

Use of chitosan bandage to prevent fatal infections developing from highly contaminated wounds in mice

et al. 2006

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HemCon ® bandage is an engineered chitosan acetate preparation used as a hemostatic control dressing, and its chemical structure suggests that it should also be antimicrobial. We tested its ability to rapidly kill bacteria in vitro and in mouse models of infected wounds. We used the Gram-negative species Pseudomonas aeruginosa and Proteus mirabilis and the Gram-positive Staphylococcus aureus that had all been stably transduced with the entire bacterial lux operon to allow in vivo bioluminescence imaging. An excisional wound in Balb/c mice was inoculated with 50-250 million cells followed after 30 min by application of HemCon bandage, alginate sponge bandage, silver sulfadiazine cream or no treatment. HemCon was more adhesive to the wound and conformed well to the injury compared to alginate. Animal survival was followed over 15 days with observations of bioluminescence emission and animal activity daily. Chitosan acetate treated mice infected with P. aeruginosa and P. mirabilis all survived while those receiving no treatment, alginate and silver sulfadiazine demonstrated 25-100% mortality. Chitosan acetate was much more effective than other treatments in rapidly reducing bioluminescence in the wound consistent with its rapid bactericidal activity in vitro as well as its light-scattering properties. S. aureus formed only non-lethal localized infections after temporary immunosuppression of the mice but HemCon was again more effective in reducing bioluminescence. The data suggest that chitosan acetate rapidly kills bacteria in the wound before systemic invasion can take place, and is superior to alginate bandage and silver sulfadiazine that may both encourage bacterial growth in the short term.

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Section: Introductionmentioning

confidence: 99%

Use of chitosan bandage to prevent fatal infections developing from highly contaminated wounds in mice

et al. 2006

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“…11 Chitin-and chitosan-based products have been advanced for a wide variety of applications, including wound healing, 12 pharmaceutical formulation, [12][13][14][15][16] tissue engineering, [17][18][19][20][21] and surface hemostasis. 22,23 However, medical product development with these materials has been hampered by the chemical and physical heterogeneity of the polymer products and contamination of preparations by proteins and other components. 3 Recently discovered nanofibers isolated from a marine microalgal source 3 consist of high molecular weigh (MW ¼ 2.8 Â 10 6 Da) linear polymers of fullyacetylated poly-N-acetyl glucosamine.…”

Section: Introductionmentioning

confidence: 99%

Hemostatic properties of glucosamine‐based materials

Fischer

Bode

Demcheva

et al. 2006

J Biomedical Materials Res

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Glucosamine-and N-acetyl glucosamine-containing polymers are being used in an increasing number of biomedical applications, including in products for surface (topical) hemostasis. The studies presented here investigate the relationship between the structure (conformation) and function (activation of hemostasis) of glucosamine-based materials. Several polymer systems were studied, including fibers isolated from a microalgal source containing poly-N-acetyl glucosamine polymers that are organized in a parallel, hydrogen-bonded tertiary structure and can be chemically modified to an antiparallel orientation; and gel formulation derivatives of the microalgal fibers consisting of partially deacetylated (F2 gel) and fully deacetylated (F3 gel) polymers. Comparison of the properties of the poly-N-acetyl glucosamine fiber-derived materials with chitin, chitosan, and commercial chitosan-based products are presented. Several studies were performed with the glucosamine-based materials, including (1) an analysis of the ability of materials to activate platelets and turnover of the intrinsic coagulation cascade, (2) an examination of the viscoelastic properties of mixtures of platelet-rich plasma and the glucosamine-based materials via thromboelastography, and (3) scanning electron microscopic studies to examine the morphology of the glucosamine-based materials. The results presented demonstrate that hemostatic responses to the glucosamine-based materials studied are highly dependent on their chemical nature and tertiary/quaternary structure. The unique natural microalgal fibers were found to have strongly prohemostatic activity compared to the other materials studied.

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“…Selected for American Red Cross program and US force, DFSD showed to be successful in animal studies focused on control of hemorrhage at liver, kidney, aorta and femoral artery [42]. Though problems about possible virus transmission were eliminated with blood donor screening, its expensive cost and need for strong protective packaging make DFSD less attractive [43].…”

Section: ) Dry Fibrin Dressingsmentioning

confidence: 99%