title: The design and testing of a dual fiber textile matrix for accelerating surface hemostasis.
abstract: The standard treatment for severe traumatic injury is frequently compression and application of gauze dressing to the site of hemorrhage. However, while able to rapidly absorb pools of shed blood, gauze fails to provide strong surface (topical) hemostasis. The result can be excess hemorrhage-related morbidity and mortality. We hypothesized that cost-effective materials (based on widespread availability of bulk fibers for other commercial uses) could be designed based on fundamental hemostatic principles to partially emulate the wicking properties of gauze while concurrently stimulating superior hemostasis. A panel of readily available textile fibers was screened for the ability to activate platelets and the intrinsic coagulation cascade in vitro. Type E continuous filament glass and a specialty rayon fiber were identified from the material panel as accelerators of hemostatic reactions and were custom woven to produce a dual fiber textile bandage. The glass component strongly activated platelets while the specialty rayon agglutinated red blood cells. In comparison with gauze in vitro, the dual fiber textile significantly enhanced the rate of thrombin generation, clot generation as measured by thromboelastography, adhesive protein adsorption and cellular attachment and activation. These results indicate that hemostatic textiles can be designed that mimic gauze in form but surpass gauze in ability to accelerate hemostatic reactions.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. tfischer@med.unc.edu
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Fischer
authors.forename: John N
authors.initials: JN
authors.lastname: Vournakis
authors.forename: James E
authors.initials: JE
authors.lastname: Manning
authors.forename: Shane L
authors.initials: SL
authors.lastname: McCurdy
authors.forename: Preston B
authors.initials: PB
authors.lastname: Rich
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Nichols
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Scull
authors.forename: Marian G
authors.initials: MG
authors.lastname: McCord
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Decorta
authors.forename: Peter C
authors.initials: PC
authors.lastname: Johnson
authors.forename: Carr J
authors.initials: CJ
authors.lastname: Smith
mesh_terms: D000328:Adult; D000818:Animals; D001777:Blood Coagulation; D001798:Blood Proteins / Q000737:chemistry; D006470:Hemorrhage / Q000628:therapy*; D006487:Hemostasis; D006490:Hemostatics; D006801:Humans; D013784:Textiles; D013916:Thrombelastography; D013917:Thrombin / Q000378:metabolism
chemical_list: D001798:Blood Proteins; D006490:Hemostatics; D013917:Thrombin