Comparison of Combat Gauze with Fibrin Sealant Patch in Hemorrhage Control after Vascular or Hepatic Trauma
Technical Report,01 Jul 2015,31 Jan 2017
University of Cincinnati Cincinnati United States
Pagination or Media Count:
Noncompressible vascular injury not amenable to the use of a tourniquet remains a significant cause of potentially preventable death on the battlefield. The recent development of fibrin patches, which combine both biologic and nonbiologic hemostatic agents, provides a potential adjunct to the current guidelines for the treatment of these injuries. We examined the effectiveness of a fibrin patch FP in comparison to the current standard of Combat Gauze CG in an established junctional hemorrhage model. Yorkshire pigs n15 were placed under general anesthesia and underwent arterial and venous line placement followed by right femoral vessel exposure. Four pigs were used as controls and underwent line placement and groin incision only. In the remaining 11 pigs, junctional femoral artery hemorrhage was created with a 6-mm aortic punch. After uncontrolled hemorrhage for 45 seconds, wounds were treated with placement of either CG n5 or FP n6, and 75 pounds of pressure was held for 3 minutes. The pigs were then resuscitated to a mean arterial pressure of 65 using 500 mL of Hextend followed by Ringers lactate at a rate of 100 mLmin to a maximum of 10 liters. The pigs were followed for 4 hours post-injury during which time they were resuscitated and vital signs were monitored. Mortality, establishment of hemostasis, re-bleeding, blood loss, and fluid resuscitation volumes were recorded for each animal. Comparison of the two groups revealed average blood loss during the hemorrhage of 207 mL for the CG group vs. 225 mL for the FP group p not significant. Survival in the CG group was 100 and 83 in the FP group p not significant. Each intervention had a 100 initial hemostasis after release of the 75-pound pressure however, 66 in the FP group and 40 in the CG group displayed re-bleeding at 3 minutes. Mean total blood loss during the experiment was 316 mL for the CG group and 962 mL for the FP arm p0.082.
- Medicine and Medical Research