Use of a modified chitosan dressing in a hypothermic coagulopathic grade V liver injury model.
BACKGROUND
Exsanguination from hepatic trauma is exacerbated by the lethal triad of acidosis, coagulopathy, and hypothermia. We evaluated the application of a modified chitosan dressing in a hypothermic coagulopathic model of grade V liver injury.


METHODS
Subject swine underwent induced hypothermic coagulopathy followed by standardized grade V liver injuries. A modified chitosan dressing was applied and compared with standard packing.


RESULTS
Pretreatment temperature, activated clotting time, and blood loss were similar between groups. Post treatment blood loss was significantly less and resuscitation mean arterial pressure were significantly greater in the modified chitosan group (P < .0001 and P < .018, respectively). Mean fluid resuscitative volume was significantly less in the modified chitosan group (P < .0056). Hemostasis was achieved on average 5.2 minutes following modified chitosan and never achieved with standard packing. At 1 hour post injury, all treatment animals survived compared with half of controls.


CONCLUSIONS
Modified chitosan dressings provide simple rapid treatment of life-threatening liver injuries.
Bochicchio
Grant
G
Department of Surgery, University of Maryland, Baltimore, MD, USA. gbochicchio@umm.edu
Kilbourne
Michael
M
Kuehn
Reed
R
Keledjian
Kaspar
K
Hess
John
J
Scalea
Thomas
T
D000818:Animals; D001458:Bandages; D001778:Blood Coagulation Disorders / Q000150:complications; D048271:Chitosan / Q000008:administration & dosage*; D004195:Disease Models, Animal; D006470:Hemorrhage / Q000517:prevention & control*; D006489:Hemostatic Techniques / Q000295:instrumentation*; D006490:Hemostatics / Q000008:administration & dosage*; D007035:Hypothermia / Q000150:complications; D008099:Liver / Q000293:injuries*; D013552:Swine
D006490:Hemostatics; D048271:Chitosan