Comparison of 10 Hemostatic Dressings in a Groin Transection Model in Swine

Arnaud, Françoise; Parreño-Sadalan, Dione; Tomori, Toshiki; Delima, Mariam Grace; Teranishi, Kohsuke; Carr, Walter; McNamee, George; McKeague, Anne; Govindaraj, Krishnanurthy; Beadling, Charles W.; Lutz, Clifford; Sharp, Trueman W.; Mog, Steven; Burris, David; McCarron, Richard M.

doi:10.1097/ta.0b013e3181b2897f

Cited by 73 publications

(60 citation statements)

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“…Evaluation of eight animals per group has been sufficient in our studies with these injury models [1,2,8] to distinguish bleeding control and high mortality rates in nontreated groups (100% mortality [8]) or standard of care (compressed gauze) groups (>75% mortality [8]). Evaluation of CBG and TMS immediately followed a series of similar dressing comparisons [1,2] and therefore no nontreatment or standard of care group was repeated.…”

Section: Discussionmentioning

confidence: 99%

“…Estimated blood volume (EBV) was calculated as: animal weight (kg) 3 65 mL /kg. Experiments with these models and methods have been previously thoroughly described [1,2]. Briefly, the animals were intubated after anesthesia induction (ketamine HCl (30 mg/kg, i.m.)…”

Section: Animal Modelmentioning

confidence: 99%

“…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: Discussionmentioning

confidence: 99%

Section: Animal Modelmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

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Injectable Self‐Expanding/Self‐Propelling Hydrogel Adhesive with Procoagulant Activity and Rapid Gelation for Lethal Massive Hemorrhage Management

Zhao,

Huang,

et al. 2024

Advanced Materials

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Developing hydrogels that can quickly reach deep bleeding sites, adhere to wounds, and expand to stop lethal and/or noncompressible bleeding in civil and battlefield environments remains a challenge. Herein, we report an injectable, antibacterial, self‐expanding, and self‐propelling hydrogel bioadhesive with procoagulant activity and rapid gelation. This hydrogel combines spontaneous gas foaming and rapid Schiff base crosslinking for lethal massive hemorrhage. Hydrogels have rapid gelation and expansion rate, high self‐expanding ratio, excellent antibacterial activity, antioxidant efficiency, and tissue adhesion capacity. In addition, hydrogels have good cytocompatibility, procoagulant ability, and higher blood cell/platelet adhesion activity than commercial combat gauze and gelatin sponge. The optimized hydrogel (OD‐C/QGQL‐A30) exhibits better hemostatic ability than combat gauze and gelatin sponge in rat liver and femoral artery bleeding models, rabbit volumetric liver loss massive bleeding models with/without anticoagulant, and rabbit liver and kidney incision bleeding models with bleeding site not visible. Especially, OD‐C/QGQL‐A30 rapidly stops the bleedings from pelvic area of rabbit, and swine subclavian artery vein transection. Furthermore, OD‐C/QGQL‐A30 has biodegradability and biocompatibility, and accelerates MRSA‐infected skin wound healing. This injectable, antibacterial, self‐expanding and self‐propelling hydrogel opens up a new avenue to develop hemostats for lethal massive bleeding, abdominal organ bleeding, and bleeding from coagulation lesions.This article is protected by copyright. All rights reserved

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Development of haemostatic decontaminants for the treatment of wounds contaminated with chemical warfare agents. 2: Evaluation of in vitro topical decontamination efficacy using undamaged skin

Dalton

Hall

Lydon

et al. 2014

J of Applied Toxicology

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The risk of penetrating, traumatic injury occurring in a chemically contaminated environment cannot be discounted. Should a traumatic injury be contaminated with a chemical warfare (CW) agent, it is likely that standard haemostatic treatment options would be complicated by the need to decontaminate the wound milieu. Thus, there is a need to develop haemostatic products that can simultaneously arrest haemorrhage and decontaminate CW agents. The purpose of this study was to evaluate a number of candidate haemostats for efficacy as skin decontaminants against three CW agents (soman, VX and sulphur mustard) using an in vitro diffusion cell containing undamaged pig skin. One haemostatic product (WoundStat™) was shown to be as effective as the standard military decontaminants Fuller's earth and M291 for the decontamination of all three CW agents. The most effective haemostatic agents were powder-based and use fluid absorption as a mechanism of action to sequester CW agent (akin to the decontaminant Fuller's earth). The envisaged use of haemostatic decontaminants would be to decontaminate from within wounds and from damaged skin. Therefore, WoundStat™ should be subject to further evaluation using an in vitro model of damaged skin.

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Comparison of 10 Hemostatic Dressings in a Groin Transection Model in Swine

Abstract: Celox, QuikClot ACS, WoundStat, and X-Sponge ranked superior in terms of low incidence of rebleeding, volume of blood loss, maintenance of mean arterial pressure >40 mm Hg, and survival.

Cited by 73 publications

References 14 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

Injectable Self‐Expanding/Self‐Propelling Hydrogel Adhesive with Procoagulant Activity and Rapid Gelation for Lethal Massive Hemorrhage Management

Development of haemostatic decontaminants for the treatment of wounds contaminated with chemical warfare agents. 2: Evaluation of in vitro topical decontamination efficacy using undamaged skin

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