title: Development of haemostatic decontaminants for the treatment of wounds contaminated with chemical warfare agents. 2: evaluation of in vitro topical decontamination efficacy using undamaged skin.
abstract: The risk of penetrating, traumatic injury occurring in a chemically contaminated environment cannot be discounted. Should a traumatic injury be contaminated with a chemical warfare (CW) agent, it is likely that standard haemostatic treatment options would be complicated by the need to decontaminate the wound milieu. Thus, there is a need to develop haemostatic products that can simultaneously arrest haemorrhage and decontaminate CW agents. The purpose of this study was to evaluate a number of candidate haemostats for efficacy as skin decontaminants against three CW agents (soman, VX and sulphur mustard) using an in vitro diffusion cell containing undamaged pig skin. One haemostatic product (WoundStat™) was shown to be as effective as the standard military decontaminants Fuller's earth and M291 for the decontamination of all three CW agents. The most effective haemostatic agents were powder-based and use fluid absorption as a mechanism of action to sequester CW agent (akin to the decontaminant Fuller's earth). The envisaged use of haemostatic decontaminants would be to decontaminate from within wounds and from damaged skin. Therefore, WoundStat™ should be subject to further evaluation using an in vitro model of damaged skin.
authors.affiliation: Biomedical Sciences, Dstl Porton Down, Salisbury, SP4 0JQ, UK; School of Biosciences, University of Birmingham, Birmingham, B15 2TT, UK.
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Dalton
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Hall
authors.forename: Helen L
authors.initials: HL
authors.lastname: Lydon
authors.forename: J K
authors.initials: JK
authors.lastname: Chipman
authors.forename: John S
authors.initials: JS
authors.lastname: Graham
authors.forename: John
authors.initials: J
authors.lastname: Jenner
authors.forename: Robert P
authors.initials: RP
authors.lastname: Chilcott
mesh_terms: D017607:Aluminum Compounds / Q000493:pharmacokinetics; D000818:Animals; D002619:Chemical Warfare Agents / Q000633:toxicity*; D003666:Decontamination / Q000379:methods*; D006490:Hemostatics / Q000493:pharmacokinetics*; D017616:Magnesium Compounds / Q000493:pharmacokinetics; D009151:Mustard Gas / Q000633:toxicity; D009946:Organothiophosphorus Compounds / Q000633:toxicity; D017640:Silicates / Q000493:pharmacokinetics; D012867:Skin / Q000187:drug effects; D012869:Skin Absorption / Q000187:drug effects; D012999:Soman / Q000633:toxicity; D013552:Swine; D014947:Wounds and Injuries / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology
chemical_list: D017607:Aluminum Compounds; D002619:Chemical Warfare Agents; D006490:Hemostatics; D017616:Magnesium Compounds; D009151:Mustard Gas; D009946:Organothiophosphorus Compounds; D017640:Silicates; D012999:Soman; C001262:Fuller's Earth; C009680:VX-agent
keywords: chemical warfare agent; diffusion cell; nerve agent; percutaneous absorption; vesicant agent