title: Effect of a chitosan-based hemostatic dressing on blood loss and survival in a model of severe venous hemorrhage and hepatic injury in swine.
abstract: BACKGROUND
  Hemorrhage is a leading cause of death from trauma. An advanced hemostatic dressing could augment available hemostatic methods. We studied the effects of a new chitosan dressing on blood loss, survival, and fluid use after severe hepatic injury in swine.
  
  
  METHODS
  Swine received chitosan dressings or gauze sponges. Standardized, severe liver injuries were induced. After 30 seconds, dressings were applied and resuscitation initiated. Blood loss, hemostasis, resuscitation volume, and 60-minute survival were quantified.
  
  
  RESULTS
  Posttreatment blood loss was reduced ( p< 0.01) in the chitosan group (264 mL; 95% confidence interval [CI], 82-852 mL) compared with the gauze group (2,879 mL; 95% CI, 788-10,513 mL). Fluid use was reduced ( p= 0.03) in the chitosan group (1,793 mL; 95% CI, 749-4,291) compared with the gauze group (6,614 mL; 95% CI, 2,519-17,363 mL). Survival was seven of eight and two of even in the chitosan and gauze groups ( p= 0.04), respectively. Hemostasis was improved in the chitosan group ( p= 0.03).
  
  
  CONCLUSIONS
  A chitosan dressing reduced hemorrhage and improved survival after severe liver injury in swine. Further studies are warranted.
authors.affiliation: Library Branch, U.S. Army Institute of Surgical Research, 3400 Rawley East Chambers Avenue, Fort Sam Houston, TX 78234-6315, USA. anthony.pusateri@cen.amedd.army.mil
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Pusateri
authors.forename: Simon J
authors.initials: SJ
authors.lastname: McCarthy
authors.forename: Kenton W
authors.initials: KW
authors.lastname: Gregory
authors.forename: Richard A
authors.initials: RA
authors.lastname: Harris
authors.forename: Luis
authors.initials: L
authors.lastname: Cardenas
authors.forename: Albert T
authors.initials: AT
authors.lastname: McManus
authors.forename: Cleon W
authors.initials: CW
authors.lastname: Goodwin
mesh_terms: D000818:Animals; D001458:Bandages / Q000592:standards*; D001810:Blood Volume; D002686:Chitin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D048271:Chitosan; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006489:Hemostatic Techniques / Q000592:standards*; D006490:Hemostatics / Q000627:therapeutic use*; D008099:Liver / Q000293:injuries*; D008297:Male; D011897:Random Allocation; D012151:Resuscitation / Q000379:methods; D016019:Survival Analysis; D013552:Swine; D013997:Time Factors
chemical_list: D006490:Hemostatics; D002686:Chitin; D048271:Chitosan