title: Efficacy of a dry fibrin sealant dressing for hemorrhage control after ballistic injury.
abstract: OBJECTIVE
  To determine if a dry fibrin sealant dressing (DFSD) will provide superior hemostasis when compared with regular gauze in a ballistic injury animal model.
  
  
  METHODS
  A nonsurvival randomized goat study.
  
  
  METHODS
  A federal biomedical research institute.
  
  
  METHODS
  Eighteen anesthetized Angora goats.
  
  
  METHODS
  Uncontrolled hemorrhage was induced by a complex ballistic extremity injury. Control of hemorrhage was achieved by applying and holding pressure with the DFSD or regular gauze for 2 minutes. The dressings were left in place for 1 hour.
  
  
  METHODS
  Total blood loss, mean arterial pressure, ballistic injury, and mortality were recorded after 1 hour.
  
  
  RESULTS
  The injuries were equivalent for the 2 groups. No animal mortality was seen. After 1 hour, the mean (+/-SEM) blood loss was 124+/-64 mL in the DFSD-treated group and 377+/-64 mL in the gauze dressings-treated group (P=.01). Twenty minutes after injury, the mean arterial pressure was 95.0 mm Hg (+/-SEM, +/-4.7 mm Hg) in the DFSD-treated group and 70.0+/-5.0 mm Hg in the gauze dressings-treated group. The difference persisted for the remainder of the study (P=.01).
  
  
  CONCLUSIONS
  The DFSD was superior to gauze in decreasing blood loss and maintaining blood pressure while retaining the simplicity of standard dressing application.
authors.affiliation: Department of Surgery, William Beaumont Army Medical Center, El Paso, Tex, USA.
authors.forename: J
authors.initials: J
authors.lastname: Holcomb
authors.forename: M
authors.initials: M
authors.lastname: MacPhee
authors.forename: S
authors.initials: S
authors.lastname: Hetz
authors.forename: R
authors.initials: R
authors.lastname: Harris
authors.forename: A
authors.initials: A
authors.lastname: Pusateri
authors.forename: J
authors.initials: J
authors.lastname: Hess
mesh_terms: D000818:Animals; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006041:Goats; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D009779:Occlusive Dressings; D011312:Pressure; D014948:Wounds, Gunshot / Q000150:complications / Q000628:therapy*
chemical_list: D015718:Fibrin Tissue Adhesive