Hydrophobically modified chitosan gauze: a novel topical hemostat

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• 作者：Apurva Chaturvedi ; BS^a ; Matthew B. Dowling ; PhD^b ; John P. Gustin ; PhD^c ; Thomas M. Scalea ; MD^b ; Srinivasa R. Raghavan ; PhD^b ; ^c ; Jason D. Pasley ; DO^a ; Mayur Narayan ; MD ; MPH ; MBA^a ; ^{mayur.narayan@utsouthwestern.edu}
• 关键词：Hemostatic gauze ; Modified chitosan gauze ; Hemostasis ; Trauma ; Hm-chitosan
• 刊名：Journal of Surgical Research
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：207
• 期：Complete
• 页码：45-52
• 全文大小：888 K
• 卷排序：207

文摘

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.MethodsTwelve Yorkshire swine were randomized to receive either hm-C gauze (n = 4), ChG (n = 4), or CG (n = 4). A standard hemorrhage model was used in which animals underwent a splenectomy before a 6-mm punch arterial puncture of the femoral artery. Thirty seconds of free bleeding was allowed before dressings were applied and compressed for 3 min. Baseline mean arterial pressure was preserved via fluid resuscitation. Experiments were conducted for 3 h after which any surviving animal was euthanized.Resultshm-C gauze was found to be at least equivalent to both CG and ChG in terms of overall survival (100% versus 75%), number of dressing used (6 versus 7), and duration of hemostasis (3 h versus 2.25 h). Total post-treatment blood loss was lower in the hm-C gauze treatment group (4.7 mL/kg) when compared to CG (13.4 mL/kg) and ChG (12.1 mL/kg) groups.Conclusionshm-C gauze outperformed both CG and ChG in a lethal hemorrhage model but without statistical significance for key endpoints. Future comparison of hm-C gauze to CG and ChG will be performed on a hypothermic, coagulopathic model that should allow for outcome significance to be differentiated under small treatment groups.