Comparison of 10 hemostatic dressings in a groin transection model in swine.
BACKGROUND
Major improvements have been made in the development of novel dressings with hemostatic properties to control heavy bleeding in noncompressible areas. To test the relative efficacy of different formulations in bleeding control, recently manufactured products need to be compared using a severe injury model.


METHODS
Ten hemostatic dressings and the standard gauze bandage were tested in anesthetized Yorkshire pigs hemorrhaged by full transection of the femoral vasculature at the level of the groin. Application of these dressings with a 5-minute compression period (at approximately 200 mm Hg) was followed with a subsequent infusion of colloid for a period of 30 minutes. Primary outcomes were survival and amount and incidence of bleeding after dressing application. Vital signs and wound temperature were continuously recorded throughout the 3-hour experimental observation.


RESULTS
These findings indicated that four dressings were effective in improving bleeding control and superior to the standard gauze bandage. This also correlated with increased survival rates. Absorbent property, flexibility, and the hemostatic agent itself were identified as the critical factors in controlling bleeding on a noncompressible transected vascular and tissue injury.


CONCLUSIONS
Celox, QuikClot ACS, WoundStat, and X-Sponge ranked superior in terms of low incidence of rebleeding, volume of blood loss, maintenance of mean arterial pressure >40 mm Hg, and survival.
Arnaud
Françoise
F
Department of Resuscitative Medicine, Naval Medical Research Center, Silver Spring, Maryland 20910-7500, USA. francoise.arnaud@med.navy.mil
Parreño-Sadalan
Dione
D
Tomori
Toshiki
T
Delima
Mariam Grace
MG
Teranishi
Kohsuke
K
Carr
Walter
W
McNamee
George
G
McKeague
Anne
A
Govindaraj
Krishnanurthy
K
Beadling
Charles
C
Lutz
Clifford
C
Sharp
Trueman
T
Mog
Steven
S
Burris
David
D
McCarron
Richard
R
D000042:Absorption; D000818:Animals; D001458:Bandages; D001704:Biopolymers / Q000627:therapeutic use; D004867:Equipment Design; D006119:Groin / Q000293:injuries; D006489:Hemostatic Techniques / Q000295:instrumentation*; D008422:Materials Testing; D012771:Shock, Hemorrhagic / Q000517:prevention & control; D013552:Swine
D001704:Biopolymers; C540163:Celox