Modified rapid deployment hemostat bandage terminates bleeding in coagulopathic patients with severe visceral injuries.
BACKGROUND
We recently reported that a new dressing, the Modified Rapid Deployment Hemostat (MRDH) controlled bleeding in hypothermic coagulopathic swine after traumatic liver avulsion. The purpose of this study was to evaluate the MRDH in coagulopathic trauma patients undergoing abbreviated laparotomy.


METHODS
A prospective, observational clinical trial of the MRDH dressing was performed at our Level One Trauma Center in patients with high-grade visceral injuries with coagulopathy who failed conventional therapy and required packing. Attending surgeons graded the injury and the adequacy of hemostasis following application of the dressing. Patients were followed until discharge or death.


RESULTS
Ten patients were enrolled: nine severe hepatic injuries, and one major abdominal vascular injury. All patients were hypothermic, acidotic, and clinically coagulopathic. Intraoperative hemostasis was immediately obtained after MRDH placement in all cases except one. There was one death.


CONCLUSIONS
The Modified Rapid Deployment Hemostat terminates bleeding from severe visceral injuries in coagulopathic patients undergoing abbreviated laparotomy.
King
David R
DR
Dewitt-Daughtry Family Department of Surgery, Division of Trauma, Trauma and Surgical Critical Care Research Institute, University of Miami School of Medicine, Miami, Florida 33136, USA.
Cohn
Stephen M
SM
Proctor
Kenneth G
KG
D000007:Abdominal Injuries / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D001458:Bandages; D001778:Blood Coagulation Disorders / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D006489:Hemostatic Techniques / Q000295:instrumentation*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014193:Trauma Centers; D016896:Treatment Outcome