A salmon thrombin-fibrin bandage controls arterial bleeding in a swine aortotomy model.
BACKGROUND
Recently, a wide variety of bandages have been formulated to attempt to improve the effectiveness of emergency intervention in situations of uncontrolled bleeding. The best of these dressings contain a mixture of human thrombin and fibrinogen. The presence of human components in these bandages, although effective, increases the cost of the dressing and raises questions of availability of raw materials and transmission of pathogens. The purpose of this study was to investigate the efficacy of dressings composed of salmon thrombin and fibrinogen in a swine aortotomy model.


METHODS
A 4.4-mm aortotomy was produced in the abdominal aorta of 19 anesthetized, splenectomized swine. The United States Army standard field gauze was applied to 8 animals, and the salmon thrombin-fibrin dressing (SFD) was applied to 11 animals. Survival, blood loss, and other parameters were measured over a 60-minute period.


RESULTS
All 11 animals that received the SFD survived the aortotomy injury, and bleeding stopped within 7.5 +/- 1.5 min. Seven of 8 animals in the control group were killed when bleeding continued and blood pressures decreased to the cutoff values as outlined in the animal protocol. Bleeding was significantly less in the SFD group compared with the gauze group (241 +/- 65.3 vs. 932.7 +/- 142.4 mL).


CONCLUSIONS
Fibrin dressing using salmon-derived thrombin and fibrinogen is effective in controlling severe, uncontrolled bleeding. This dressing may offer an alternative to dressings composed of human coagulation proteins.
Rothwell
Stephen W
SW
Department of Blood Research, Walter Reed Army Institute of Research, Silver Spring, Maryland 20910-7500, USA. stephen.rothwell@us.army.mil
Reid
Thomas J
TJ
Dorsey
Jennifer
J
Flournoy
William S
WS
Bodo
Michael
M
Janmey
Paul A
PA
Sawyer
Evelyn
E
D000818:Animals; D001012:Aorta, Abdominal / Q000293:injuries*; D001458:Bandages; D005337:Fibrin / Q000494:pharmacology*; D006439:Hemodynamics; D006470:Hemorrhage / Q000628:therapy*; D006490:Hemostatics / Q000494:pharmacology*; D012474:Salmon; D013552:Swine; D013917:Thrombin / Q000494:pharmacology*
D006490:Hemostatics; D005337:Fibrin; D013917:Thrombin