Efficacy of Hemostatic Gauzes in a Swine Model of Prolonged Field Care with Limb Movement
| Autor: | Ramesh Natarajan, Micah J Gaspary, Michael Boboc, Gregory J Zarow, Cassandra Townsend, Brian Thorne, Grace D Landers, R. Kachur, Jose Henao, S. Stuart |
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| Rok vydání: | 2020 |
| Předmět: |
Swine
0211 other engineering and technologies Context (language use) Hemorrhage 02 engineering and technology Femoral artery Hemostatics 03 medical and health sciences 0302 clinical medicine medicine.artery Medicine Animals Hemostatic gauze Groin injury 021110 strategic defence & security studies business.industry Hemostatic Techniques Public Health Environmental and Occupational Health 030208 emergency & critical care medicine General Medicine Hemostatic technique Bandages Femoral Artery Disease Models Animal Anesthesia Hemorrhage control business |
| Zdroj: | Military medicine. 186(Suppl 1) |
| ISSN: | 1930-613X |
| Popis: | IntroductionProlonged field care for junctional wounds is challenging and involves limb movement to facilitate transport. No studies to date have explored the efficacy of gauze products to limit rebleeding in these scenarios.Materials and MethodsWe randomly assigned 48 swine to QuikClot Combat Gauze, ChitoGauze, NuStat Tactical, or Kerlix treatment groups (12 each) and then inflicted a severe groin injury by utilizing a modified Kheirabadi model of a 6-mm femoral artery punch followed by unrestricted bleeding for 60 seconds. We reassessed rebleed following limb movement at 30 minutes of stabilization and 4 hours after stabilization.ResultsSwine treated with Combat Gauze proved to have the lowest incidence of rebleeding, and conversely, NuStat Tactical had the highest incidence of rebleeding at wounds after limb movement. Importantly, rebleeds occurred at a rate of 25%-58% across all swine treatment groups at 30 minutes postinjury and 0%-42% at 270 minutes postinjury demonstrating that limb movements universally challenge hemostatic junctional wounds.ConclusionsOur findings highlight the difficulty of controlling hemorrhage from junctional wounds with hemostatic gauze in the context of prolonged field care and casualty transport. Our research can guide selection of hemorrhage control gauze when patients have prolonged field extraction or difficult transport. Our data demonstrates the frequency of junctional wound rebleeding after movement and thus the importance of frequent patient reassessment. |
| Databáze: | OpenAIRE |
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