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combat gauze

Apurva Chaturvedi, Matthew B Dowling, John P Gustin, Thomas M Scalea, Srinivasa R Raghavan, Jason D Pasley, Mayur Narayan
BACKGROUND: Currently, the standard of care for treating severe hemorrhage in a military setting is Combat Gauze (CG). Previous work has shown that hydrophobically modified chitosan (hm-C) has significant hemostatic capability relative to its native chitosan counterpart. This work aims to evaluate gauze coated in hm-C relative to CG as well as ChitoGauze (ChG) in a lethal in vivo hemorrhage model. METHODS: Twelve Yorkshire swine were randomized to receive either hm-C gauze (n = 4), ChG (n = 4), or CG (n = 4)...
January 2017: Journal of Surgical Research
Z Adamiak, D Bukowiecka, P Jastrzębski, M Jałyński, P Holak, J Głodek, G Gudzbeler
Hemorrhaging from large vessels poses a serious problem in emergency situations when blood loss needs to be immediately controlled. The aim of the study was to compare the effectiveness of two hemostatic dressings in controlling bleeding from a surgically punctured femoral artery. The study was performed on thirteen pigs divided into two groups, of six and seven pigs, respectively. Combat gauze covered with ChitoClear hqg 95 chitosan and Protanal LF10/60 FT sodium alginate was used in the first group, seton covered with identical substances was uses in the second group...
September 1, 2016: Polish Journal of Veterinary Sciences
I Otrocka-Domagała, P Jastrzębski, Z Adamiak, K Paździor-Czapula, M Gesek, M Mikiewicz, T Rotkiewicz
The purpose of this study was to examine the safety of the long-term application of QuikClot Combat Gauze, ChitoGauze PRO and Celox Gauze using a swine model. The study was conducted on nine pigs weighing approximately 30 kg, which were randomly divided into three groups. Under deep anesthesia, the pigs underwent complete transverse cutting of the femoral artery in the groin region. Hemostatic dressings were left in the wound for 24 hours. The animals were euthanized 24 hours after dressing application. In each group, macroscopic and microscopic severe changes and shock symptoms were observed in the lungs, liver, kidneys and heart...
2016: Polish Journal of Veterinary Sciences
Rachel L Choron, Joshua P Hazelton, Krystal Hunter, Lisa Capano-Wehrle, John Gaughan, John Chovanes, Mark J Seamon
BACKGROUND: Intra-abdominal packing with laparotomy pads (LP) is a common and rapid method for hemorrhage control in critically injured patients. Combat Gauze™ and Trauma Pads™ ([QC] Z-Medica QuikClot(®)) are kaolin impregnated hemostatic agents, that in addition to LP, may improve hemorrhage control. While QC packing has been effective in a swine liver injury model, QC remains unstudied for human intra-abdominal use. We hypothesized QC packing during damage control laparotomy (DCL) better controls hemorrhage than standard packing and is safe for intracorporeal use...
January 2017: Injury
Jennifer Leonard, John Zietlow, David Morris, Kathleen Berns, Steven Eyer, Kurt Martinson, Donald Jenkins, Scott Zietlow
BACKGROUND: Life-threatening hemorrhage is a leading cause of preventable mortality in trauma patients. Since publication of the Hartford Consensus statement, there has been intense interest in civilian use of commercial hemostatic gauze and tourniquets. Although the military has studied their use on soldiers with wartime injuries, there are limited data on patient outcomes following civilian prehospital use and no data on the use in rural trauma. METHODS: We performed a multi-institutional retrospective analysis of clinical outcomes following prehospital use of QuikClot combat gauze (QC) and combat application tourniquets (CATs) from 2009 to 2014...
September 2016: Journal of Trauma and Acute Care Surgery
James R Baylis, Alexander E St John, Xu Wang, Esther B Lim, Matthew L Statz, Diana Chien, Eric Simonson, Susan A Stern, Richard T Liggins, Nathan J White, Christian J Kastrup
Hemorrhage is the leading cause of preventable death in trauma, and hemorrhage from noncompressible junctional anatomic sites is particularly difficult to control. The current standard is QuikClot Combat Gauze packing, which requires 3 min of compression. We have created a novel dressing with calcium carbonate microparticles that can disperse and self-propel upstream against flowing blood. We loaded these microparticles with thrombin and tranexamic acid and tested their efficacy in a swine arterial bleeding model without wound compression...
September 2016: Shock
Huixi Li, Lin Wang, Amjad Alwaal, Yung-Chin Lee, Amanda Reed-Maldonado, Taylor A Spangler, Lia Banie, Reginald B O'Hara, Guiting Lin
BloodSTOP iX Battle Matrix (BM) and QuikClot Combat Gauze (CG) have both been used to treat traumatic bleeding. The purpose of this study was to examine the efficacy and initial safety of both products in a swine extremity arterial hemorrhage model, which mimics combat injury. Swine (37.13 ± 0.56 kg, NBM = 11, NCG = 9) were anesthetized and splenectomized. We then isolated the femoral arteries and performed a 6 mm arteriotomy. After 45 s of free bleeding, either BM or CG was applied. Fluid resuscitation was provided to maintain a mean arterial pressure of 65 mmHg...
April 12, 2016: International Journal of Molecular Sciences
Sean P Conley, Lanny F Littlejohn, Jose Henao, Sara S DeVito, Gregory J Zarow
OBJECTIVE: Uncontrolled hemorrhage from junctional wounds that cannot be controlled by traditional tourniquets accounts for one in five preventable battlefield exsanguination deaths. Products for treating these wounds are costly and require special training. However, chemically treated gauze products are inexpensive, potentially effective, and require only minimal training. This study was designed to assess the efficacy of three hemostatic gauze products following brief training, using a consensus swine groin injury model...
November 2015: Military Medicine
Przemysław Kluj, Dawid Aleksandrowicz, Waldemar Machała, Tomasz Gaszyński
Hemostatic agents are currently used in the form of special granules or soaked gauze. Their use is particularly advantageous in difficult body location (e.g. on neck, armpit or groin), where other methods of bleeding control are impossible to use or fail. In a tactical environment tranexamic acid received first class recommendation for use in case of severe bleeding in the US Army. Its application should be considered in case of traumatic amputation, penetrating chest and abdominal trauma or hemorrhagic shock...
September 2015: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Avi Shina, Ari M Lipsky, Roy Nadler, Moran Levi, Avi Benov, Yuval Ran, Avraham Yitzhak, Elon Glassberg
BACKGROUND: Hemostatic dressings are advanced topical dressings designed to control hemorrhage by enhancing clot formation. These dressings may be effective when used on injuries sustained in junctional zones. The Israeli Defense Forces Medical Corps (IDF-MC) chose to equip its medical personnel with the QuikClot Combat Gauze. There is a paucity of data describing clinical use and results of hemostatic dressing especially at the point of injury. The purpose of this article was to report the IDF-MC experience with prehospital use of the QuikClot Combat Gauze in junctional zones in a case series retrieved from the IDF Trauma Registry...
October 2015: Journal of Trauma and Acute Care Surgery
Stéphane Travers, Hugues Lefort, Eric Ramdani, Sabine Lemoine, Daniel Jost, Michel Bignand, Jean-Pierre Tourtier
To report the use and describe the interest of hemostatic dressings in a civilian setting, we provided medical prehospital teams with QuikClot Combat Gauze (QCG) and asked physicians to complete a specific questionnaire after each use. Thirty uses were prospectively reported. The wounds were mostly caused by cold steel (n=15) and were primarily cervicocephalic (n=16), with 19/30 active arterial bleedings. For 26/30 uses, hemostatic dressing was justified by the inefficiency of other hemostasis techniques. Those 30 applications were associated with 22 complete cessations of bleeding, six decreases of bleeding, and ineffectiveness in two cases...
October 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Alexander E St John, Xu Wang, Esther B Lim, Diana Chien, Susan A Stern, Nathan J White
BACKGROUND: Hemostatic gauzes, which must be packed into wounds and compressed for several minutes, may be of limited use for noncompressible wounds in junctional anatomic locations. Rapid mechanical wound sealing is an alternative approach that seals the wound at the skin, allowing internal clot formation. We evaluate wound sealing for junctional hemorrhage control using a hemostatic clamp (iTClamp). METHODS: Severe junctional hemorrhage was induced in anesthetized immature female swine using a 5-mm femoral arteriotomy...
August 2015: Journal of Trauma and Acute Care Surgery
Jose Garcia-Blanco, Brian Gegel, James Burgert, Sabine Johnson, Don Johnson
BACKGROUND: The purpose of this study was to compare the effectiveness of QuikClot(®) Combat Gauze™ (QCG) to a control wound dressing to withstand movement in a porcine model with hemodilution and hypothermia. DESIGN: This was a prospective study with a between-subjects experimental design. Twenty-six Yorkshire swine were randomly assigned to two groups: QCG (n = 13) or a control dressing (n = 13). METHODS: The subjects were exsanguinated to 30% of the blood volume; hypothermia was induced for 10 minutes...
2015: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Don Johnson, Douglas M Westbrook, Deanna Phelps, Jose Blanco, Michael Bentley, James Burgert, Brian Gegel
OBJECTIVES: The aims of the study were to 1) determine the effectiveness of QuikClot Combat Gauze (QCG); 2) determine the arterial blood pressure at which rebleeding occurs; 3) determine how much intravenous fluid could be administered before hemorrhage reoccurred, and 4) determine the number extremity movement on rebleeding when QCG was used. DESIGN: This was a prospective, randomized, experimental study. SUBJECTS: Adult Yorkshire pigs were randomly assigned to two groups QCG (n = 10) or control (n = 10)...
2014: American Journal of Disaster Medicine
Don Johnson, Sheri Bates, Sofiya Nukalo, Amy Staub, Aaron Hines, Taylor Leishman, Jennifer Michel, Dusti Sikes, Brian Gegel, James Burgert
Hemorrhage is the leading cause of death from trauma. Intravenous (IV) fluid resuscitation in these patients may cause hemodilution and secondary hemorrhage. In addition, hypothermia may interfere with coagulation. The purposes of this study were to compare the effectiveness QuikClot Combat Gauze (QCG) to a control group on hemorrhage in a hemodiluted, hypothermic model, and to determine the effects of IV volume resuscitation on rebleeding. This was a prospective, between subjects, experimental design. Yorkshire swine were randomly assigned to two groups: QCG (n = 13) or control (n = 13)...
June 2014: Annals of Medicine and Surgery
Genevieve R Hillis, Crystal J Yi, David L Amrani, Troy W Akers, Richard Schwartz, Ian Wedmore, John G McManus
BACKGROUND: Uncontrolled hemorrhage remains one of the most challenging problems facing emergency medical professionals and a leading cause of traumatic death in both battlefield and civilian environments. Survival is determined by the ability to rapidly control hemorrhage. Several commercially available topical adjunct agents have been shown to be effective in controlling hemorrhage, and one, Combat Gauze (CG), is used regularly on the battlefield and for civilian applications. However, recent literature reviews have concluded that no ideal topical agent exists for all injuries and scenarios...
2014: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Brad L Bennett, Lanny F Littlejohn, Bijan S Kheirabadi, Frank K Butler, Russ S Kotwal, Michael A Dubick, Jeffrey A Bailey
Hemorrhage remains the leading cause of combat death and a major cause of death from potentially survivable injuries. Great strides have been made in controlling extremity hemorrhage with tourniquets, but not all injuries are amenable to tourniquet application. Topical hemostatic agents and dressings have also contributed to success in controlling extremity and compressible junctional hemorrhage, and their efficacy continues to increase as enhanced products are developed. Since the addition of Combat Gauze™ (Z-Medica Corporation, Wallingford, CT, USA; http://www...
2014: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Bijan S Kheirabadi, Irasema B Terrazas, Nahir Miranda, J Scot Estep, Benjamin T Corona, John F Kragh, Michael A Dubick
BACKGROUND: Groin application of Combat Ready Clamp (CRoC) in pigs elicits an acute inflammation in underlying ischemic tissues. This study examined functional recovery of pigs' hind leg(s) following 2 hours of CRoC application. METHODS: Left femoral arteries were isolated and injured in anesthetized pigs. Following 25% hemorrhage, CRoC was applied on the inguen for 2 hours (n = 6), and wounds were covered with combat gauze (CG). Bleeding was treated in the control animals (n = 5) with CG only...
September 2014: Journal of Trauma and Acute Care Surgery
Judson Vincent Edwards, Nicolette Prevost
Wound healing is a complex series of biochemical and cellular events. Optimally, functional material design addresses the overlapping acute and inflammatory stages of wound healing based on molecular, cellular, and bio-compatibility issues. In this paper the issues addressed are uncontrolled hemostasis and inflammation which can interfere with the orderly flow of wound healing. In this regard, we review the serine proteases thrombin and elastase relative to dressing functionality that improves wound healing and examine the effects of charge in cotton/cellulosic dressing design on thrombin production and elastase sequestration (uptake by the wound dressing)...
2011: Journal of Functional Biomaterials
Emily M Abbott, Sreeharsha V Nandyala, Richard M Schwend
STUDY DESIGN: Retrospective case-control study. OBJECTIVE: To evaluate the hemostatic benefits of using a kaolin-impregnated dressing during pediatric spinal deformity correction surgery. SUMMARY OF BACKGROUND DATA: Minimizing blood loss and transfusions are clear benefits for patient safety. A technique common in both severe trauma and combat medicine that has not been reported in the spine literature is wound packing with a kaolin-impregnated hemostatic dressing...
September 1, 2014: Spine
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