Document Detail


A novel highly porous silica and chitosan-based hemostatic dressing is superior to HemCon and gauze sponges.
MedLine Citation:
PMID:  18849807     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hemostatic dressings have become increasingly popular as the optimal initial treatment for severe hemorrhage. The purpose of this study was to compare the hemostatic properties of a novel highly porous silica and chitosan-based dressing (TraumaStat) to HemCon, and gauze dressing in a severe groin injury model in swine. METHODS: Thirty swine were blindly randomized to receive TraumaStat, HemCon, or standard gauze dressing for hemostatic control. A complex groin injury involving complete transaction of the femoral artery and vein was made. After 30 seconds of uncontrolled hemorrhage, the randomized dressing was applied and pressure was held for 5 minutes. Fluid resuscitation was initiated to achieve and maintain the baseline mean arterial pressure and the wound was inspected for bleeding. Failure of hemostasis was defined as pooling of blood outside of the wound. Animals were then monitored for 120 minutes and surviving animals were euthanized. RESULTS: Blood loss before treatment was similar between groups (p > 0.1). TraumaStat had one failure, compared with five for gauze, and eight for HemCon (p = 0.005, TraumaStat vs. HemCon). TraumaStat significantly reduced median blood loss when compared with both HemCon and gauze (117 vs. 774 and 268 mL respectively, p < 0.05). At study conclusion, TraumaStat animals had a greater median hematocrit than both HemCon (24 vs. 19, p = 0.033), and gauze (24 vs. 19, p = 0.049) animals. Median volume of fluid resuscitation and mortality were not different between groups (p > 0.1). CONCLUSIONS: TraumaStat was superior to HemCon and gauze dressings in controlling bleeding from a severe groin injury. TraumaStat may be a better hemostatic dressing for control of active hemorrhage than current standards of care.
Authors:
Michael S Englehart; S David Cho; Brandon H Tieu; Melanie S Morris; Samantha J Underwood; Ayhan Karahan; Patrick J Muller; Jerome A Differding; David H Farrell; Martin A Schreiber
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of trauma     Volume:  65     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-13     Completed Date:  2008-11-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  884-90; discussion 890-2     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Trauma/Critical Care Section, Oregon Health & Science University, Portland, Oregon 97239, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Blood Loss, Surgical / prevention & control
Chi-Square Distribution
Chitosan / pharmacology*
Disease Models, Animal
Female
Femoral Vein / surgery
Fibrin Tissue Adhesive / pharmacology
Hemorrhage / therapy*
Hemostatic Techniques / instrumentation*
Hemostatics / pharmacology*
Male
Occlusive Dressings*
Probability
Random Allocation
Risk Factors
Sensitivity and Specificity
Silicon Dioxide / pharmacology
Statistics, Nonparametric
Swine
Chemical
Reg. No./Substance:
0/Fibrin Tissue Adhesive; 0/Hemostatics; 7631-86-9/Silicon Dioxide; 9012-76-4/Chitosan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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