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新型止血基质在猪交界性出血模型中的测试与评估

Testing and Evaluation of a Novel Hemostatic Matrix in a Swine Junctional Hemorrhage Model.

作者信息

Angus Andrew A, July Lindsey N, McCarthy Patrick M, Shepard Nola D, Rall Jason M, Radowsky Jason S

机构信息

Department of Surgery, Brooke Army Medical Center, JBSA-Fort Sam Houston, Texas.

Department of Surgery, Brooke Army Medical Center, JBSA-Fort Sam Houston, Texas; DHA Joint Trauma System, JBSA-Fort Sam Houston, Texas.

出版信息

J Surg Res. 2023 Nov;291:452-458. doi: 10.1016/j.jss.2023.06.040. Epub 2023 Jul 29.

Abstract

INTRODUCTION

In an ongoing effort to improve survival and reduce blood loss from hemorrhagic injuries on the battlefield, new hemostatic dressings continue to be developed. This study aimed to determine the efficacy of a novel silicon dioxide-based hemostatic matrix (HM) and compare it with the current military standard Quikclot Combat Gauze (QCG) utilizing a lethal femoral artery injury model.

MATERIALS AND METHODS

The femoral arteries of 20 anesthetized swine were isolated, and an arteriotomy was performed. After a 45 s free bleed, the wound was treated with either HM or QCG (n = 10 per group). Following a 60-min observation period, ipsilateral leg manipulations and angiography were performed. Animal survival, hemostasis, blood loss, exothermic reaction, and femoral artery patency were analyzed.

RESULTS

Despite a volumetric size discrepancy between the two products tested, the survival rate was similar between the two groups (80% HM, 90% QCG, n = 10, P = 0.588). Immediate hemostasis was obtained in 50% of HM animals and 40% of QCG animals. There was no difference in total blood loss recorded between the two groups (P = 0.472). Femoral artery patency rates following ipsilateral leg manipulations were similar between the two groups (50% HM, 33% QCG, P = 0.637), with no contrast extravasation in HM-treated wounds (0% HM, 33% QCG, P = 0.206). There was no significant difference in either pretreatment or posttreatment laboratory values, and there were no exothermic reactions in either group.

CONCLUSIONS

The SiOxMed HM demonstrated comparable hemostatic efficacy to QCG. The tested form of HM may be appropriate for surgical or topical hemostasis applications, and with further product development, it could be used for battlefield trauma implementation.

摘要

引言

为了不断提高战场上因出血性损伤导致的生存率并减少失血,新型止血敷料不断被研发出来。本研究旨在利用致死性股动脉损伤模型,确定一种新型二氧化硅基止血基质(HM)的疗效,并将其与当前军事标准的快速凝血战斗纱布(QCG)进行比较。

材料与方法

分离20只麻醉猪的股动脉,并进行动脉切开术。在自由出血45秒后,用HM或QCG处理伤口(每组n = 10)。经过60分钟的观察期后,进行同侧腿部操作和血管造影。分析动物的生存率、止血情况、失血量、放热反应和股动脉通畅情况。

结果

尽管所测试的两种产品在体积大小上存在差异,但两组的生存率相似(HM组80%,QCG组90%,n = 10,P = 0.588)。50%的HM组动物和40%的QCG组动物实现了即时止血。两组记录的总失血量没有差异(P = 0.472)。两组同侧腿部操作后的股动脉通畅率相似(HM组50%,QCG组33%,P = 0.637),HM处理的伤口没有造影剂外渗(HM组0%,QCG组33%,P = 0.206)。治疗前或治疗后的实验室值均无显著差异,两组均无放热反应。

结论

SiOxMed HM显示出与QCG相当的止血效果。所测试形式的HM可能适用于手术或局部止血应用,随着产品的进一步开发,可用于战场创伤救治。

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