title: A salmon thrombin-fibrinogen dressing controls hemorrhage in a swine model compared to standard kaolin-coated gauze.
abstract: BACKGROUND
  Battlefield hemorrhage remains the primary cause of death in potentially survivable combat injuries with noncompressible hemorrhage. Fibrin dressings have great potential for reducing mortality, however are limited by cost, availability, and disease transmission.
  
  
  METHODS
  Dressings comprising a soluble dextran dressing with lyophilized salmon thrombin and fibrinogen (STF) were tested against Combat Gauze (CG) as a control in a standard swine femoral artery hemorrhage model. Ten female swine were used in each arm of the study.
  
  
  RESULTS
  Survival, blood loss, and time to hemostasis were similar between the two dressings. Two of the CGtreated animals that survived exsanguinated during the simulated walking maneuver. Three CG-treated animals formed a clot within the wound, but the clot did not adhere to the femoral artery injury. All ten of the STF-treated animals formed a clot in the wound that adhered and sealed the arterial injury site, even in three animals that did not survive. None of the STF-treated animals bled following the simulated walking maneuver. Three of five STF-treated animals reestablished blood flow distal to the injury as demonstrated by angiography.
  
  
  CONCLUSIONS
  The STF dressing is as efficacious as CG in treating hemorrhage in this model of a lethal injury. Further, the STF dressing formed a fibrin sealant over the injury, whereas CG achieved hemostasis by occlusive compression of the artery. The sealant property of the STF dressing allowed reestablishment of antegrade blood flow into the distal limb, demonstrating that this dressing has the potential of limb salvage in addition to control of life-threatening hemorrhage.
authors.forename: C Timothy
authors.initials: CT
authors.lastname: Floyd
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Rothwell
authors.forename: Roy
authors.initials: R
authors.lastname: Martin
authors.forename: Jack
authors.initials: J
authors.lastname: Risdahl
authors.forename: Curtis E
authors.initials: CE
authors.lastname: Olson
mesh_terms: D000818:Animals; D001458:Bandages; D004195:Disease Models, Animal; D005340:Fibrinogen; D006470:Hemorrhage / Q000628:therapy; D006489:Hemostatic Techniques; D007616:Kaolin; D012474:Salmon; D013552:Swine; D013917:Thrombin
chemical_list: D007616:Kaolin; D005340:Fibrinogen; D013917:Thrombin