Quote:
Originally Posted by Trapper John
Hmm, is a vendor's website really the most objective evaluation?  Independent studies have shown that chitosan impregnated gauzes work faster than kaolin based products. Probably an important performance criteria - doesn't require the 2-3 minutes of constant pressure and when you are being shot at that could be critical. And as I said, I like the mechanism of action for chitosan over kaolin, but then again I'm a science geek.  |
Here is the latest article on hemostatis agents by the military: in Journal Of Trauma, August Supplement
Comparison of novel hemostatic dressings with QuikClot
combat gauze in a standardized swine model of
uncontrolled hemorrhage
Jason M. Rall, PhD, Jennifer M. Cox, BS, Adam G. Songer, MD, Ramon F. Cestero, MD,
and James D. Ross, PhD, San Antonio, Texas
BACKGROUND: Uncontrolled hemorrhage is the leading cause of preventable death on the battlefield. The development, testing, and application of
novel hemostatic dressings may lead to a reduction of prehospitalmortality through enhanced point-of-injury hemostatic control. This study
aimed to determine the efficacy of currently available hemostatic dressings as compared with the current Committee for Tactical Combat
Casualty Care Guidelines standard of treatment for hemorrhage control (QuikClot Combat Gauze [QCG]).
METHODS: The femoral artery of anesthetized Yorkshire pigs was isolated and punctured. Free bleeding was allowed to proceed for 45 seconds
before packing of QCG, QuikClot Combat Gauze XL (QCX), Celox Trauma Gauze (CTG), Celox Gauze (CEL), or HemCon ChitoGauze
(HCG), into the wound. After 3 minutes of applied, direct pressure, fluid resuscitation was administered to elevate and maintain a mean
arterial pressure of 60mmHg or greater during the 150-minute observation time.Animal survival, hemostasis, and blood lossweremeasured
as primary end points. Hemodynamic and physiologic parameters, along with markers of coagulation, were recorded and analyzed.
RESULTS: Sixty percent ofQCG-treated animals (controls) survived through the 150-minute observation period.QCX, CEL, andHCGwere observed
to have higher rates of survival in comparison to QCG (70%, 90%, and 70% respectively), although these results were not found to be of
statistical significance in pairwise comparison to QCG. Immediate hemostasis was achieved in 30% of QCG applications, 80% of QCX,
70% of CEL, 60% of HCG, and 30% of CTG-treated animals. Posttreatment blood loss varied from an average of 64 mL/kg with CTG
to 29 mL/kg with CEL, but no significant difference among groups was observed.
CONCLUSION: These results suggest that the novel hemostatic devices perform at least as well as the current Committee on Tactical Combat Casualty
Care standard for point-of-injury hemorrhage control. Despite their different compositions and sizes, the lack of clear superiority of any
agent suggests that contemporary hemostatic dressing technology has potentially reached a plateau for efficacy. (J Trauma Acute Care
Surg. 2013;75: S150YS156. Copyright * 2013 by Lippincott Williams & Wilkins)
KEY WORDS: Hemostatics; hemostatic: dressings; hemostatic: gauze; hemorrhage: swine.