Hydrophobically Modified Chitosan Gauze for Control of Massive Hemorrhage.

摘要

Currently, the standard of care for treating severe hemorrhage in a military setting is Combat GauzeTM (CG). Previous work has shown that hydrophobically modified (hm) chitosan has great hemostatic potential. This work aims to create an hm chitosan-coated gauze to compare to CG as well as ChitoGauze (ChG) in an in vivo hemorrhage model. Twelve Yorkshire swine were randomized to receive either hm chitosan gauze (n = 4), ChG (n = 4), or CG (n = 4). We found hm chitosan gauze to be at least equivalent to CG and ChG in terms of overall survival (100% vs. 75%), number of dressings used (6 vs. 7), and duration of hemostasis (3 hours vs. 2.25 hours). Total post-treatment blood loss was lower in the hm chitosan gauze treatment group (4.7 mL/kg) when compared to the CG (13.4 mL/kg) and ChG (12.1 mL/kg) groups. In a lethal hemorrhage model, hm chitosan gauze appears to have outperformed both CG and ChG. However, given the small treatment group size, the only measured outcome that was significantly different was total posttreatment blood loss. Future work will be performed on a hypothermic and coagulopathic model that should allow for outcome significance to be differentiated under small treatment groups.