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

Michael S. Englehart, S. David Cho, Brandon Tieu, Melanie S. Morris, Samantha J. Underwood, Ayhan Karahan, Patrick J. Muller, Jerome A. Differding, David Farrell, Martin Schreiber

Research output: Contribution to journalArticle

48 Citations (Scopus)

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)
Pages (from-to)884-890
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume65
Issue number4
DOIs
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

Keywords

  • Gauze
  • HemCon
  • Hemorrhagic shock
  • Hemostatic dressing
  • Trauma

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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; Morris, Melanie S.; Underwood, Samantha J.; Karahan, Ayhan; Muller, Patrick J.; Differding, Jerome A.; Farrell, David; Schreiber, Martin.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 65, No. 4, 10.2008, p. 884-890.

Research output: Contribution to journalArticle

Englehart, Michael S. ; Cho, S. David ; Tieu, Brandon ; Morris, Melanie S. ; Underwood, Samantha J. ; Karahan, Ayhan ; Muller, Patrick J. ; Differding, Jerome A. ; Farrell, David ; Schreiber, Martin. / A novel highly porous silica and chitosan-based hemostatic dressing is superior to hemcon and gauze sponges. In: Journal of Trauma - Injury, Infection and Critical Care. 2008 ; Vol. 65, No. 4. pp. 884-890.
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AU - Underwood, Samantha J.

AU - Karahan, Ayhan

AU - Muller, Patrick J.

AU - Differding, Jerome A.

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