Comparison of Hemostatic Efficacy of ChitoGauze and Combat Gauze in a Lethal Femoral Arterial Injury in Swine Model.

摘要

Uncontrolled hemorrhage is the leading cause of death of soldiers in wartime. Quickly accessing and stabilizing the wound with effective hemostatic techniques is the key to saving lives on the battlefield. There exists a need for a hemostat that is efficacious in achieving hemostasis in severe traumatic combat wounds and easy to apply. The ChitoGauze dressing is composed of polyester/rayon blend non-woven medical gauze that is coated with chitosan. The four inch by four yard (4 x 4 yds) dressing is z-folded and packaged in a peelable foil pouch and is terminally sterilized. The hemostatic properties of chitosan enhance the ability of the medical gauze to control bleeding. ChitoGauze also offers antibacterial properties against a wide range of gram positive and gram negative organisms, including methicillin resistant Staphylococcus aureus ATCC33591 (MRSA), Enterococcus faecalis ATCC51299 (VRE) and Acinetobacter baumannii ATCC15308. In this study, we evaluated the hemostatic efficacy of two advanced hemostatic wound dressings: ChitoGauze (trademark) (HemCon Medical Technologies Inc., Portland, OR) and QuikClot (registered trademark) Combat Gauze (trademark) (ZMedica Co., Wallingford, CT), in a swine femoral arterial injury model. Surgical information including body weight, pre-treatment blood loss, vessel size and MAP change were similar between the two treatment groups. Average post treatment blood loss over three hours or survival was less in the ChitoGauze group than the Combat Gauze group (430 mL vs. 1180 mL). In the ChitoGauze group, seven (87.5%) animals achieved hemostasis and survived with minimal blood loss or oozing. Only two (25%) animals achieved immediate hemostasis and five (63%, p = 0.04) survived in the three hours observation time in the Combat Gauze group. In the survived animals, five out of seven animals had complete hemostasis in first attempt using the ChitoGauze; two out of five animals achieved hemostasis in first attempt with the Combat Gauze.