A novel highly porous silica and chitosan-based hemostatic dressing is superior to HemCon and gauze sponges.

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

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalThe Journal of trauma
Volume65
Issue number4
StatePublished - Oct 2008

Fingerprint

Chitosan
Porifera
Hemostatics
Bandages
Silicon Dioxide
Groin
Hemorrhage
Wounds and Injuries
Swine
Femoral Vein
Femoral Artery
Standard of Care
Hemostasis
Resuscitation
Arterial Pressure
Pressure
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A novel highly porous silica and chitosan-based hemostatic dressing is superior to HemCon and gauze sponges. / Englehart, Michael S.; Cho, S. David; Tieu, Brandon H.; Morris, Melanie S.; Underwood, Samantha J.; Karahan, Ayhan; Muller, Patrick J.; Differding, Jerome A.; Farrell, David H.; Schreiber, Martin A.

In: The Journal of trauma, Vol. 65, No. 4, 10.2008.

Research output: Contribution to journalArticle

Englehart, MS, Cho, SD, Tieu, BH, Morris, MS, Underwood, SJ, Karahan, A, Muller, PJ, Differding, JA, Farrell, DH & Schreiber, MA 2008, '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.
Englehart, Michael S. ; Cho, S. David ; Tieu, Brandon H. ; Morris, Melanie S. ; Underwood, Samantha J. ; Karahan, Ayhan ; Muller, Patrick J. ; Differding, Jerome A. ; Farrell, David H. ; Schreiber, Martin A. / A novel highly porous silica and chitosan-based hemostatic dressing is superior to HemCon and gauze sponges. In: The Journal of trauma. 2008 ; Vol. 65, No. 4.
@article{6e5d1b39a09d4940bb343f502f412158,
title = "A novel highly porous silica and chitosan-based hemostatic dressing is superior to HemCon and gauze sponges.",
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.",
author = "Englehart, {Michael S.} and Cho, {S. David} and Tieu, {Brandon H.} and Morris, {Melanie S.} and Underwood, {Samantha J.} and Ayhan Karahan and Muller, {Patrick J.} and Differding, {Jerome A.} and Farrell, {David H.} and Schreiber, {Martin A.}",
year = "2008",
month = "10",
language = "English (US)",
volume = "65",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

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

Y1 - 2008/10

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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=56149126937&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=56149126937&partnerID=8YFLogxK

M3 - Article

VL - 65

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 4

ER -