Successful use of a military-grade haemostatic agent for a major head and neck bleed.
BACKGROUND
Major haemorrhage is a catastrophic complication occurring in 3-4 per cent of head and neck cancer patients. Massive haemorrhage also causes 50 per cent of preventable deaths in combat situations. There has been a surge of interest in the development of effective haemostatic products in the military, with chitosan being one such product.


METHODS
A 48-year-old lady presented with a life-threatening head and neck bleed. She was known to have a malignant peripheral nerve sheath sarcoma originating from the left parapharyngeal space. Bleeding was successfully controlled with the application of Celox™ granules, a chitosan-based product currently used in the military.


CONCLUSIONS
This paper describes the first known use of a military haemostatic agent to control a malignant head and neck bleed. Celox granules can be poured directly onto a wound to enhance haemorrhage control. The suggested mechanism of action and reports of current uses of haemostatic agents are described.
Department of Plastic Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
R
R
Crunkhorn
R
R
Burnham
G
G
Walton
D001704:Biopolymers / Q000627:therapeutic use; D048271:Chitosan / Q000627:therapeutic use; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications; D006470:Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006489:Hemostatic Techniques; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D008889:Military Personnel; D018317:Nerve Sheath Neoplasms / Q000150:complications*
D001704:Biopolymers; C540163:Celox; D006490:Hemostatics; D048271:Chitosan