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A novel highly porous silica and chitosan-based hemostatic dressing is superior to HemCon and gauze sponges.
J Trauma. 2008 Oct; 65(4):884-90; discussion 890-2.JT

Abstract

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+Show Affiliations

Department of Surgery, Trauma/Critical Care Section, Oregon Health & Science University, Portland, Oregon 97239, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18849807

Citation

Englehart, Michael S., et al. "A Novel Highly Porous Silica and Chitosan-based Hemostatic Dressing Is Superior to HemCon and Gauze Sponges." The Journal of Trauma, vol. 65, no. 4, 2008, pp. 884-90; discussion 890-2.
Englehart MS, Cho SD, Tieu BH, et al. A novel highly porous silica and chitosan-based hemostatic dressing is superior to HemCon and gauze sponges. J Trauma. 2008;65(4):884-90; discussion 890-2.
Englehart, M. S., Cho, S. D., Tieu, B. H., Morris, M. S., Underwood, S. J., Karahan, A., Muller, P. J., Differding, J. A., Farrell, D. H., & Schreiber, M. A. (2008). A novel highly porous silica and chitosan-based hemostatic dressing is superior to HemCon and gauze sponges. The Journal of Trauma, 65(4), 884-90; discussion 890-2. https://doi.org/10.1097/TA.0b013e318187800b
Englehart MS, et al. A Novel Highly Porous Silica and Chitosan-based Hemostatic Dressing Is Superior to HemCon and Gauze Sponges. J Trauma. 2008;65(4):884-90; discussion 890-2. PubMed PMID: 18849807.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A novel highly porous silica and chitosan-based hemostatic dressing is superior to HemCon and gauze sponges. AU - Englehart,Michael S, AU - Cho,S David, AU - Tieu,Brandon H, AU - Morris,Melanie S, AU - Underwood,Samantha J, AU - Karahan,Ayhan, AU - Muller,Patrick J, AU - Differding,Jerome A, AU - Farrell,David H, AU - Schreiber,Martin A, PY - 2008/10/14/pubmed PY - 2008/11/19/medline PY - 2008/10/14/entrez SP - 884-90; discussion 890-2 JF - The Journal of trauma JO - J Trauma VL - 65 IS - 4 N2 - 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. SN - 1529-8809 UR - https://www.unboundmedicine.com/medline/citation/18849807/A_novel_highly_porous_silica_and_chitosan_based_hemostatic_dressing_is_superior_to_HemCon_and_gauze_sponges_ L2 - http://dx.doi.org/10.1097/TA.0b013e318187800b DB - PRIME DP - Unbound Medicine ER -