title: Comparison of 10 hemostatic dressings in a groin transection model in swine.
abstract: 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.
authors.affiliation: Department of Resuscitative Medicine, Naval Medical Research Center, Silver Spring, Maryland 20910-7500, USA. francoise.arnaud@med.navy.mil
authors.forename: Françoise
authors.initials: F
authors.lastname: Arnaud
authors.forename: Dione
authors.initials: D
authors.lastname: Parreño-Sadalan
authors.forename: Toshiki
authors.initials: T
authors.lastname: Tomori
authors.forename: Mariam Grace
authors.initials: MG
authors.lastname: Delima
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Teranishi
authors.forename: Walter
authors.initials: W
authors.lastname: Carr
authors.forename: George
authors.initials: G
authors.lastname: McNamee
authors.forename: Anne
authors.initials: A
authors.lastname: McKeague
authors.forename: Krishnanurthy
authors.initials: K
authors.lastname: Govindaraj
authors.forename: Charles
authors.initials: C
authors.lastname: Beadling
authors.forename: Clifford
authors.initials: C
authors.lastname: Lutz
authors.forename: Trueman
authors.initials: T
authors.lastname: Sharp
authors.forename: Steven
authors.initials: S
authors.lastname: Mog
authors.forename: David
authors.initials: D
authors.lastname: Burris
authors.forename: Richard
authors.initials: R
authors.lastname: McCarron
mesh_terms: 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
chemical_list: D001704:Biopolymers; C540163:Celox