QuikClot Combat Gauze for Hemorrhage Control

Basadonna, Giacomo

doi:10.1017/s1049023x12000490

Cited by 9 publications

(7 citation statements)

References 7 publications

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“…To overcome these problems, various hemostatic sealants have been applied at the conclusion of tubeless PNL and have showed favorable postoperative outcomes [5]. The most common hemostatic agents used in tubeless PNL are fibrin glue, gelatin matrix, and oxidized cellulose, all of which are absorbable agents that have been evaluated in clinical studies [9,[11][12][13][14][15]. However, knowledge of their exact effects on renal drainage and reaction at contact with tissue or urine is limited, although such effects must be considered when applying these agents to clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…We introduced the use of Quikclot ® as an attempt to avoid permanent instillation of such hemostatic sealants. Quikclot ® is a non-woven surgical gauze impregnated with kaolin, an inert mineral that promotes clotting via contact activation [11]. Kaolin directly interacts with Factor XII, the first protein of the intrinsic pathway of the clotting cascade, and shows unique efficacy in controlling both venous and arterial bleeding [19].…”

Section: Discussionmentioning

confidence: 99%

“…Quikclot ® is a non-absorbable surgical gauze impregnated with kaolin [11]. Due to its unique efficacy in controlling both venous and arterial bleeding, it has widely been used in military action and percutaneous coronary procedures [11].…”

Section: Introductionmentioning

confidence: 99%

“…Due to its unique efficacy in controlling both venous and arterial bleeding, it has widely been used in military action and percutaneous coronary procedures [11]. To our knowledge, it has never been tested as a hemostatic sealant for tubeless PNL.…”

Section: Introductionmentioning

confidence: 99%

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Tubeless percutaneous nephrolithotomy with non-absorbable hemostatic sealant (Quikclot®) versus nephrostomy tube placement: a propensity score-matched analysis

et al. 2015

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The purpose of this study was to determine the efficacy and safety of tubeless percutaneous nephrolithotomy (PNL) using a non-absorbable hemostatic sealant (Quikclot(®)) as an adjunct compared to nephrostomy tube placement in patients exhibiting significant parenchymal bleeding following PNL. We identified 113 PNL cases performed between May 2011 and October 2014. For patients with insignificant parenchymal bleeding following stone removal, defined as a clear visualization of the surgical field at full irrigation of the nephroscope, tubeless PNL was performed. For patients with significant parenchymal bleeding, we introduced the tubeless Quikclot(®) technique as of September 2013 and have performed it ever since. Formerly, nephrostomy placement PNL was performed. In this study, 40 Quikclot(®) applied PNL cases were matched with an equal number of nephrostomy placement cases by propensity scoring based on body mass index, stone size, and Guy's stone score. The mean postoperative drop in hematocrit was comparative between the Quikclot(®) group and the nephrostomy group on both postoperative days 1 (p = 0.459) and 2 (p = 0.325). Quikclot(®) application was associated with lower VAS scores throughout the postoperative period, lower cumulative analgesic requirement (p = 0.025), and with shorter hospitalization (p = 0.002). Complication rates were comparable with no need for blood transfusions in any patients. Tubeless Quikclot(®) PNL was safe and provided effective hemostasis of significant parenchymal bleeding. By avoiding nephrostomy placement, we were able to reduce postoperative pain, analgesic requirements, and hospitalization. Application of Quikclot(®) may be considered prior to nephrostomy placement in patients with significant parenchymal bleeding.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tubeless percutaneous nephrolithotomy with non-absorbable hemostatic sealant (Quikclot®) versus nephrostomy tube placement: a propensity score-matched analysis

et al. 2015

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“…Of note, QCG is different in its production and hemostatic mechanism than the first generation hemostatic, QuikClot (QC) manufactured by the same company. This first-generation agent was a zeolite-based material but was discontinued in 2008 due to concerns of exothermic reactions resulting in adjacent tissue damage at the time of application (66,67). QCG was approved by FDA for external application in 2013 (68,69).…”

Section: Qcgmentioning

confidence: 99%

Emerging approaches to pre-hospital hemorrhage control: a narrative review

Jamal

Saini²,

Quencer³

et al. 2021

Ann Transl Med

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In the United States, trauma claims the lives of over 150,000 civilians each year. In military settings, trauma and exsanguination result in 50% of combat related deaths. The majority of these deaths result from uncontrolled non-compressible hemorrhage. Non-compressible hemorrhage often results from deep vascular injuries within the torso, however can also occur secondary to penetrating injuries that involve the extremities. Given the high mortality rates for non-compressible hemorrhage, rapid and effective management of patients suffering from hemorrhage is essential to good patient outcomes. Consequently, there has been increasing interest in solutions for point-of-injury hemorrhage control in trauma and military medicine. Undoubtedly there is a great need for prehospital hemostatic interventions that can be deployed by trained and untrained personnel. Since 2001, various hemostatic agents have been developed, each with its advantages based upon the type and severity of injury, wound size, wound location, accessibility to injury site, and the coagulation status of the patient. These agents are often used in the military setting as a temporizing measure prior to definitive therapy and include techniques such as resuscitative endovascular balloon occlusion of the aorta (REBOA) and bioengineered agents including ResQFoam, RevMedx's XSTAT, Tranexamic acid (TXA), and QuikClot Combat Gauze (QCG). Here, we review the indications, composition, technique, efficacy, and outcomes of these hemostatic agents.

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