Bleeding Control Using Hemostatic Dressings: Lessons Learned

Abstract

Based on lessons learned, many military battlefield trauma advances ultimately transition to enhance civilian trauma care. However, even with major strides to enhance battlefield hemorrhage control, it is unclear how effectively these techniques and products are being translated to civilian trauma. The purpose of this brief review is to present the evidence of current hemostatic product effectiveness, determine the evidence for transitioning of this technology to prehospital civilian application, and provide recommendations about potential use in the wilderness/austere setting. It is concluded that there is adequate evidence of hemorrhage control effectiveness in both military and civilian preclinical studies and clinical case series. The Committee on Tactical Combat Casualty Care recommends implementing approved hemostatic dressings as one part of a comprehensive hemorrhage control training and clinical management program. These recommendations for hemostatic dressings use by public safety and laypersons should be applied in acute transport urban settings or during prolonged care in austere environments.

Chitosan-Based Bioactive Hemostatic Agents with Antibacterial Properties—Synthesis and Characterization

“…Restoration of hemostasis after injury is still an ongoing challenge despite the numerous researches in this area. Massive blood loss can be a consequence of a transport accident or may occur on the battlefield [1,2,3]. Hemorrhage appears also during surgeries and as a result of certain diseases [4,5,6,7].…”

“…Currently there are a few types of hemostatic agents, such as physical agents, resorbable agents, biological agents, synthetic agents and dressings [1,2]. The most popular ones are biodegradable gelatin and collagen foams, fibrin sealants as well as chitosan granules, sponges and dressings [1,2,3,4,5,6,7]. Hemostatic agents may be used in hospitals and by individuals.…”

Prehospital haemostatic dressings for trauma: a systematic review

“…The US military has favoured QuikClot Combat Gauze since 2008,39 and the Israel Defence Forces have nominated it as their agent of choice 34. In the UK military, Celox-coated gauze has been favoured since the update to the Clinical Guidelines for Operations in 2013 40.…”

Hemostatic agents for prehospital hemorrhage control: a narrative review

“…z-medica.com/), Celox gauze (Medtrade Products Ltd., Crewe, UK; http://www.celoxmedical.com/usa/products/ celox-gauze/) and ChitoGauze (HemCon Medical Technologies, Portland, OR, USA; http://www.hemcon.com/). These hemostatic dressings have been recommended in the US military Tactical Combat Casualty Care guidelines [52,53] and have been covered in a recent systematic review [54]. HEMO-fiber gauze (CoreLeader Biotech Co., Ltd., New Taipei City, Taiwan, China; www.coreleaderbio.com) has emerged as an alternative.…”