A novel highly porous silica and chitosan-based hemostatic dressing is superior to HemCon and gauze sponges.
BACKGROUND
Hemostatic dressings have become increasingly popular as the optimal initial treatment for severe hemorrhage. The purpose of this study was to compare the hemostatic properties of a novel highly porous silica and chitosan-based dressing (TraumaStat) to HemCon, and gauze dressing in a severe groin injury model in swine.


METHODS
Thirty swine were blindly randomized to receive TraumaStat, HemCon, or standard gauze dressing for hemostatic control. A complex groin injury involving complete transaction of the femoral artery and vein was made. After 30 seconds of uncontrolled hemorrhage, the randomized dressing was applied and pressure was held for 5 minutes. Fluid resuscitation was initiated to achieve and maintain the baseline mean arterial pressure and the wound was inspected for bleeding. Failure of hemostasis was defined as pooling of blood outside of the wound. Animals were then monitored for 120 minutes and surviving animals were euthanized.


RESULTS
Blood loss before treatment was similar between groups (p > 0.1). TraumaStat had one failure, compared with five for gauze, and eight for HemCon (p = 0.005, TraumaStat vs. HemCon). TraumaStat significantly reduced median blood loss when compared with both HemCon and gauze (117 vs. 774 and 268 mL respectively, p < 0.05). At study conclusion, TraumaStat animals had a greater median hematocrit than both HemCon (24 vs. 19, p = 0.033), and gauze (24 vs. 19, p = 0.049) animals. Median volume of fluid resuscitation and mortality were not different between groups (p > 0.1).


CONCLUSIONS
TraumaStat was superior to HemCon and gauze dressings in controlling bleeding from a severe groin injury. TraumaStat may be a better hemostatic dressing for control of active hemorrhage than current standards of care.
Englehart
Michael S
MS
Department of Surgery, Trauma/Critical Care Section, Oregon Health & Science University, Portland, Oregon 97239, USA.
Cho
S David
SD
Tieu
Brandon H
BH
Morris
Melanie S
MS
Underwood
Samantha J
SJ
Karahan
Ayhan
A
Muller
Patrick J
PJ
Differding
Jerome A
JA
Farrell
David H
DH
Schreiber
Martin A
MA
D000818:Animals; D016063:Blood Loss, Surgical / Q000517:prevention & control; D016009:Chi-Square Distribution; D048271:Chitosan / Q000494:pharmacology*; D004195:Disease Models, Animal; D005260:Female; D005268:Femoral Vein / Q000601:surgery; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology; D006470:Hemorrhage / Q000628:therapy*; D006489:Hemostatic Techniques / Q000295:instrumentation*; D006490:Hemostatics / Q000494:pharmacology*; D008297:Male; D009779:Occlusive Dressings; D011336:Probability; D011897:Random Allocation; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012822:Silicon Dioxide / Q000494:pharmacology; D018709:Statistics, Nonparametric; D013552:Swine
D015718:Fibrin Tissue Adhesive; D006490:Hemostatics; D012822:Silicon Dioxide; D048271:Chitosan