Evaluation of Silver Coated Hemostatic Dressing to Control Hemorrhage in a Porcine Model of Lethal Vascular Injury
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The aim of the study. An ideal hemostatic dressing that would control bleeding and protect the wound from further contamination is still being sought for combat casualty care. The new SilverLeaf™ (SL) bandage was made of material containing active hemostatic property and possible antimicrobial property from silver coating. This study was conducted to compare and ascertain the hemostatic properties of SL and compare it with known hemostatic dressings: Combat Gauze® (CG) and WoundStat™ (WS) in a swine model with punch, vascular injury.Material and methods. Three hemostatic dressings were evaluated in anesthetized Yorkshire swine hemorrhaged for 45 sec in a femoral arterial puncture model. The hemostatic dressings SL, CG, or WS were applied on an actively bleeding wound, followed by 5 minutes of compression at 200 mm Hg. The pressure was then released to baseline and skin closed with towel clamps. After 15 minutes, 500 ml of (Hextend) resuscitation fluid infused over a period of 30 minutes. The animal's vital signs were monitored for the 3-hour experiment period. Primary outcomes documented were incidence of bleeding after application of the dressing, restoration of MAP and rate of survival.Results. The pre-treatment blood loss for WS was 375.66 ml (16.49%), SL 282.08 ml (12.15%) and CG 307.24 ml (12.68%) and was comparable between groups (p>0.56). The post-treatment blood loss for WS was 286.05 ml (10.65%), SL 386.81 ml (16.92%), and CG 525.76 ml (21.52%). There was no significant difference in post-treatment blood loss (p>0.37) between groups. The Mean Arterial Pressure (MAP) did not significantly differ between the groups at all time points compared. The SL and CG had comparable MAPS during the first hour. The SL had a slight advantage, but didn't reach statistical significance. This suggests that all the bandages were comparable. The two time points at which the post-treatment bleeding occurred in the three groups after the release of manual compression and after restoration of blood pressure. The post-treatment re-bleeding rates were 22.22% (2/9) for WS and SL, 44.44% (4/9) for CG. The survival rates were 100% for WS, 88.89% for SL, and 77.78% for CG.Conclusion. The findings indicate that SilverLeaf, WoundStat and Combat Gauze were comparable in controlling bleeding, preventing re-bleeding, maintenance of mean arterial pressure and improving survival following treatment.
1 - 6 - 2011
25 - 7 - 2011
- Bellamy RF: The causes of death in conventional land warfare: implications for combat casualty care research. Mil Med 1984; 149(2): 55-62.
- Ruterbusch VL, Swiergosz MJ, Montgomery LD et al.: ONR/MARCORSYSCOM Evaluation of Self-Applied Tourniquets for Combat Applications. United States Navy Experimental Diving Unit Technical Report 2005; NEDU-TR-05-15.
- Cyr DL, Johnson SB: "Basic First Aid". National Ag Safety Database 2006; http://www.nasdonline.org/docs/d000701-d000800/d000799/d000799.html
- Hill JP, Montgomery LD, Hopper KW et al.: Evaluation of Self-Applied Tourniquets for Combat Applications, Second Phase. US Navy Experimental Diving Unit Technical Report 2007; NEDU-TR-07-07.
- Kragh JF, Walters TJ, Baer DG et al.: Practical Use of Emergency Tourniquets to Stop Bleeding In Major Limb Trauma. J Trauma 2008; 64: 38-49.[Crossref][WoS]
- Arnaud F, Parreno-Sacdalan D, Tomori T et al.: Comparison of 10 hemostatic dressings in a groin transection model in swine. J Trauma 2009; 67: 848-55.[WoS]
- Kheirabadi BS, Mace JE, Terrazas IB et al.: Safety evaluation of new hemostatic agents, smectite granules, and kaolin-coated gauze in a vascular injury wound model in swine. Trauma 2010; 68: 269-78.[WoS]
- Gustafson SB, Fulkerson P, Bildfell R et al.: Chitosan dressing provides hemostasis in swine femoral arterial injury model. Prehosp Emerg Care 2007; 11: 172-78.[WoS][Crossref][PubMed]
- Atiyeh BS, Costagliola M, Hayek SN et al.: Effect of silver on burn wound infection control and healing: review of the literature. Burns 2007; 33: 139-48.[WoS][PubMed][Crossref]
- Qin Y: Silver-containing alginate fibres and dressings. Int Wound J 2005; 2: 172-6.[Crossref]
- Carraway JW, Kent D, Young K et al.: Comparison of a New Mineral Based Hemostatic Agent to a Commercially Available Granular Zeolite Agent for Hemostasis in a Swine Model of Lethal Extremity Arterial Hemorrhage. Resuscitation 2008; 78: 230-35.[WoS][Crossref]
- Kheirabadi BS, Sherer MJ, Estep JS et al.: Comparison of New Hemostatic Granules/Powders with Currently Deployed Hemostatic Products in a Lethal Model of Extremity Arterial Hemorrhage in Swine. J Trauma 2009; 66: 316-28.[WoS][Crossref]
- Pusateri, AE, McCarthy SJ, Gregory KW et al.: Effect of a Chitosan-Based Hemostatic Dressing on Blood Loss and Survival in a Model of Severe Venous Hemorrhage and Hepatic Injury in Swine. J Trauma 2003; 4: 177-82.[Crossref]
- Kheirabadi BS, Mace JE, Terrazas IB et al.: Clot-inducing minerals versus plasma protein dressing for topical treatment of external bleeding in the presence of coagulopathy. J Trauma. 2010; 69: 1062-72; discussion 1072-73.[Crossref]
- Arnaud F, Teranishi K, Okada T et al.: Comparison of Combat Gauze and TraumaStat in Two Severe Groin Injury Models. J Surg Res 2010; (in press): 1-7.[WoS]
- Kheirabadi BS, Edens JW, Terrazas IB et al.: Comparison of new hemostatic granules/powders with currently deployed hemostatic products in a lethal model of extremity arterial hemorrhage in swine. J Trauma 2009; 66: 316-26.[WoS][Crossref]
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