Department of Trauma and Resuscitative Medicine, Naval Medical Research Center, Silver Spring, Maryland 20910-7500, USA.
J Surg Res. 2011 Jul;169(1):92-8. doi: 10.1016/j.jss.2009.09.004. Epub 2009 Sep 25.
Fabric-like hemostatic dressings offer promise for hemorrhage control in noncompressible areas, especially given their similarity in form to standard gauze currently in use. Recently, two such products, Combat Gauze (CBG) and TraumaStat (TMS), were introduced. Their performance is evaluated in two vascular injury models.
The dressings were evaluated in anesthetized Yorkshire pigs, hemorrhaged by full transection of the femoral vasculature with 2 min free bleeding period (CBG = 6, TMS = 6) or by 4 mm femoral arterial puncture with 45 s free bleeding period (CBG = 8, TMS = 8). After injury, dressings were applied, followed by 5 min of manual compression and then 500 mL resuscitation fluid infused over 30 min. Vital signs, blood pressure, and blood loss were recorded throughout the 3-h experiment. Bleeding control was the primary outcome.
All animals had similar pretreatment mean arterial pressure (MAP) (∼ 36.5 mmHg); pretreatment blood loss following injury was similar for both dressing groups in the two models [24% ± 8% estimated blood volume (EBV) 2 min after transection and 17% ± 4% EBV 45 s after puncture. Incidence of post-treatment bleeding, primarily occurring after release of manual compression or restoration of blood pressure, was more frequent in the puncture model (17% with both CBG and TMS) than the transection model (57% with CBG versus 75% with TMS). Post-treatment blood loss not controlled by the dressing was 19% ± 22% and 31% ± 17% EBV, for CBG and TMS, respectively. Survival rate was 100% for both dressings in the transection model, and was 88% for CBG and 50% for TMS in the puncture model.
These findings indicated that CBG and TMS were similarly effective in improving hemostasis. These two fabric-like dressings showed easy application and removal, leaving a clean wound for surgical repair.
类似织物的止血敷料在控制非压迫性区域出血方面具有很大的潜力，尤其是因为它们的形状与目前正在使用的标准纱布相似。最近，推出了两种这样的产品，即 Combat Gauze（CBG）和 TraumaStat（TMS）。在两种血管损伤模型中评估了它们的性能。
在麻醉的约克郡猪中评估了这些敷料，通过股血管完全横断造成 2 分钟自由出血期（CBG = 6，TMS = 6）或通过 4mm 股动脉穿刺造成 45 秒自由出血期（CBG = 8，TMS = 8）造成损伤。在损伤后，应用敷料，然后进行 5 分钟的手动压迫，然后在 30 分钟内输注 500 毫升复苏液。整个 3 小时实验过程中记录生命体征、血压和失血量。止血是主要的观察结果。
所有动物在预处理时的平均动脉压（MAP）相似（约 36.5mmHg）；在两种模型中，两种敷料组在损伤后的预处理失血量相似[2 分钟后横断时为 24%±8%估计失血量（EBV），45 秒后穿刺时为 17%±4% EBV]。在手动压迫释放或血压恢复后发生的治疗后出血的发生率在穿刺模型中更为频繁（CBG 和 TMS 均为 17%），而在横断模型中则较低（CBG 为 57%，TMS 为 75%）。未被敷料控制的治疗后失血分别为 CBG 和 TMS 的 19%±22%和 31%±17% EBV。在横断模型中，两种敷料的存活率均为 100%，在穿刺模型中，CBG 为 88%，TMS 为 50%。
这些发现表明 CBG 和 TMS 在改善止血方面同样有效。这两种类似织物的敷料表现出易于应用和去除，为手术修复留下了干净的伤口。
