The RDH bandage: hemostasis and survival in a lethal aortotomy hemorrhage model.
BACKGROUND
The Rapid Deployment Hemostat (RDH) Bandage has been designed in collaboration with the Office of Naval Research for the treatment of bleeding because of extremity trauma. It is intended as both a battlefield and civilian severe trauma wound dressing. It consists of a specific formulation of Marine Polymer Technologies' proprietary hemostatic polymer poly-N-acetyl glucosamine, and has received FDA clearance. This study compares the hemostatic capabilities of the RDH Bandage with the standard U.S Army First Aid Field Bandage (AFAFB), utilizing a controlled lethal aortotomy model of hemorrhage.


METHODS
Aortic punch wounds 4 mm in diameter were made in the abdominal aortas of female Yorkshire White swine, and were allowed to bleed for 5 s before application of test materials. Test hemostats were applied to the wound with manual compression for 10 min. Total loss of blood was determined in each experiment. Bandages were removed at the end of 2 h, for those animals that survived, and the onset of re-bleeding was observed. Animals were monitored for an additional 30 min to assess survival following bandage removal. Hemostatic efficacy was judged by the total loss of blood, and the survival of the animals.


RESULTS
Eighty percent of the animals treated with the RDH Bandage survived the study through the entire protocol, whereas only 40% of those treated with the Army First Aid Field Bandage survived the removal of manual compression step, and none survived following the removal of bandage after the 2 h observation/monitoring period. The average blood loss for the RDH Bandage treated animals was 234 ml, and the average blood loss for the Army First Aid Field Bandage treated animals was 1071 ml, through the observation/monitoring period.


CONCLUSIONS
The RDH Bandage is significantly superior to the standard issue U.S. Army First Aid Field Bandage in the control of hemorrhage in a lethal swine abdominal aortotomy hemorrhage model, resulting in decreased blood loss and increased survival.
Vournakis
John N
JN
Marine Polymer Technologies, Inc, Danvers, Massachusetts 01923, USA. johnv@webmpt.com
Demcheva
Marina
M
Whitson
Anne B
AB
Finkielsztein
Sergio
S
Connolly
Raymond J
RJ
D000818:Animals; D001011:Aorta / Q000293:injuries*; D001458:Bandages; D005121:Extremities / Q000293:injuries*; D005260:Female; D006489:Hemostatic Techniques / Q000295:instrumentation*; D008887:Military Medicine; D023421:Models, Animal; D012771:Shock, Hemorrhagic / Q000517:prevention & control*; D016019:Survival Analysis; D013552:Swine; D014857:Warfare; D014947:Wounds and Injuries / Q000628:therapy*