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一种基于高孔隙率二氧化硅和壳聚糖的止血敷料在猪严重腹股沟损伤模型中控制出血方面表现优异。

A highly porous silica and chitosan-based hemostatic dressing is superior in controlling hemorrhage in a severe groin injury model in swine.

作者信息

Sambasivan Chitra N, Cho S David, Zink Karen A, Differding Jerome A, Schreiber Martin A

机构信息

Department of Surgery, Trauma/Critical Care Section, Oregon Health & Science University, Portland, OR 97239, USA.

出版信息

Am J Surg. 2009 May;197(5):576-80; discussion 580. doi: 10.1016/j.amjsurg.2008.12.011.

Abstract

BACKGROUND

This study compared the efficacy of 3 hemostatic dressings in a severe groin injury model in swine.

METHODS

Twenty-three swine received TraumaStat (OreMedix, Lebanon, OR), Chitoflex (HemCon, Inc., Portland, OR), or standard gauze for hemostasis. Complete femoral vessel transections were followed by 30 seconds of uncontrolled hemorrhage. The groin was packed with the randomized dressing followed by 30 seconds of compression. Resuscitation with lactated Ringer's solution commenced immediately postcompression to the preinjury mean arterial blood pressure. Hemostasis failure was defined as blood pooling outside the wound. Animals were monitored and maintained at the preinjury mean arterial pressure for 120 minutes, culminating with euthanization.

RESULTS

There were no differences in baseline values between groups. TraumaStat resulted in less hemostasis failure (P < .05), decreased postcompression blood loss (P < .05), and decreased fluid requirement (P < .05). No significant difference in mortality was seen between groups. There were no differences between standard gauze and Chitoflex with respect to dressing failure, posttreatment blood loss, or fluid resuscitation.

CONCLUSIONS

TraumaStat performed significantly better than Chitoflex and standard gauze in controlling hemorrhage from a severe groin injury in swine.

摘要

背景

本研究比较了三种止血敷料在猪严重腹股沟损伤模型中的疗效。

方法

23头猪分别接受TraumaStat(OreMedix公司,黎巴嫩,俄勒冈州)、Chitoflex(HemCon公司,波特兰,俄勒冈州)或标准纱布进行止血。完全切断股血管后,进行30秒的无控制出血。用随机分配的敷料填充腹股沟,然后压迫30秒。压迫结束后立即用乳酸林格氏液进行复苏,使血压恢复到伤前平均动脉血压水平。止血失败定义为伤口外有血液积聚。对动物进行监测,并将其平均动脉血压维持在伤前水平120分钟,最后实施安乐死。

结果

各组间基线值无差异。TraumaStat导致的止血失败更少(P < 0.05),压迫后失血量减少(P < 0.05),液体需求量减少(P < 0.05)。各组间死亡率无显著差异。标准纱布和Chitoflex在敷料失败、治疗后失血量或液体复苏方面无差异。

结论

在控制猪严重腹股沟损伤出血方面,TraumaStat的表现明显优于Chitoflex和标准纱布。

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