Editorial to accompany 'a pilot study of the use of kaolin-impregnated gauze (Combat Gauze) for packing high-grade hepatic injuries in a hypothermic coagulopathic swine model'

摘要

It was not too long ago that I received a "stat" page to the operating room from an OB/GYN colleague who ran into some trouble during a urinary incontinence procedure involving blind passage of a transvaginal tape. After passage of the tape via a 1- to 2-cm perineal incision, the team encountered some bleeding that rapidly increased in speed and volume. The incision and tract were rapidly packed with standard gauze, with little to no improvement. On my arrival I encountered a hypotensive patient who was exsanguinating from a major distal iliac venous injury via a perineal stab incision, and standard gauze packing was not helping. As I mulled over the options for emergently exposing this injury and getting vascular control in the deep pelvis, I remembered that our emergency department had started stocking some advanced hemostatic dressings for use in trauma cases.