title: Development of haemostatic decontaminants for treatment of wounds contaminated with chemical warfare agents. 3: Evaluation of in vitro topical decontamination efficacy using damaged skin.
abstract: Previous studies have demonstrated that haemostatic products with an absorptive mechanism of action retain their clotting efficiency in the presence of toxic materials and are effective in decontaminating chemical warfare (CW) agents when applied to normal, intact skin. The purpose of this in vitro study was to assess three candidate haemostatic products for effectiveness in the decontamination of superficially damaged porcine skin exposed to the radiolabelled CW agents, soman (GD), VX and sulphur mustard (HD). Controlled physical damage (removal of the upper 100 μm skin layer) resulted in a significant enhancement of the dermal absorption of all three CW agents. Of the haemostatic products assessed, WoundStat™ was consistently the most effective, being equivalent in performance to a standard military decontaminant (fuller's earth). These data suggest that judicious application of haemostatic products to wounds contaminated with CW agents may be a viable option for the clinical management of casualties presenting with contaminated, haemorrhaging injuries. Further studies using a relevant animal model are required to confirm the potential clinical efficacy of WoundStat™ for treating wounds contaminated with CW agents. Copyright © 2017 John Wiley & Sons, Ltd.
authors.affiliation: Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency, Chilton, UK.|University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Lydon
authors.affiliation: Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency, Chilton, UK.|University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Hall
authors.affiliation: University of Birmingham, Edgbaston, Birmingham, UK.|Dstl Porton Down, Salisbury, UK.
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Dalton
authors.affiliation: University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: J Kevin
authors.initials: JK
authors.lastname: Chipman
authors.affiliation: Medical Toxicology Branch Analytical Toxicology Division, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD, 21010, USA.
authors.forename: John S
authors.initials: JS
authors.lastname: Graham
authors.affiliation: Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency, Chilton, UK.|Research Centre for Topical Drug Delivery and Toxicology, University of Hertfordshire, Hatfield, UK.
authors.forename: Robert P
authors.identifier: 0000-0002-8845-9400
authors.initials: RP
authors.lastname: Chilcott
mesh_terms: D000287:Administration, Topical; D000818:Animals; D002619:Chemical Warfare Agents / Q000633:toxicity*; D003666:Decontamination / Q000379:methods*; D055808:Drug Discovery; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage / Q000627:therapeutic use*; D066298:In Vitro Techniques; D008297:Male; D012867:Skin / Q000187:drug effects / Q000293:injuries*; D012869:Skin Absorption; D034421:Sus scrofa; D014950:Wounds, Penetrating / Q000188:drug therapy*
chemical_list: D002619:Chemical Warfare Agents; D006490:Hemostatics
keywords: O-pinacolyl methylphosphonofluoridate (GD); S-[2-(diisopropylamino)ethyl]-O-ethyl methylphosphonothioate (VX); bis(2-chloroethyl) sulphide (HD); chemical warfare agent; decontamination; diffusion cell; haemostatic; nerve agent; percutaneous absorption; vesicant agent