An Alternative Hemostatic Dressing: Comparison of CELOX, HemCon, and QuikClot

Objectives:  Uncontrolled hemorrhage remains a leading cause of traumatic death. Several topical adjunct agents have been shown to be effective in controlling hemorrhage, and two, chitosan wafer dressing (HemCon [HC]) and zeolite powder dressing (QuikClot [QC]), are being utilized regularly on the b...

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Bibliographic Details
Published in:Academic emergency medicine 2008-01, Vol.15 (1), p.74-81
Main Authors: Kozen, Buddy G., Kircher, Sara J., Henao, Jose, Godinez, Fermin S., Johnson, Andrew S.
Format: Article
Language:English
Subjects:
Animals
Bandages
Blood
Blood Pressure
Body Temperature
CELOX
chitosan
Chitosan - administration & dosage
Disease Models, Animal
Emergency medical care
Female
Groin - injuries
Hemorrhage
Hemorrhage - drug therapy
Hemorrhage - etiology
hemostatic dressing
Hemostatics - administration & dosage
Medical procedures
Military Medicine - instrumentation
Powders
Random Allocation
Swine
Treatment Outcome
uncontrolled hemorrhage
Wound healing
Wounds and Injuries - complications
zeolite
Zeolites - administration & dosage
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Summary:Objectives:  Uncontrolled hemorrhage remains a leading cause of traumatic death. Several topical adjunct agents have been shown to be effective in controlling hemorrhage, and two, chitosan wafer dressing (HemCon [HC]) and zeolite powder dressing (QuikClot [QC]), are being utilized regularly on the battlefield. However, recent literature reviews have concluded that no ideal topical agent exists. The authors compared a new chitosan granule dressing (CELOX [CX]) to HC, QC and standard dressing in a lethal hemorrhagic groin injury. Methods:  A complex groin injury with transection of the femoral vessels and 3 minutes of uncontrolled hemorrhage was created in 48 swine. The animals were then randomized to four treatment groups (12 animals each). Group 1 included standard gauze dressing (SD); Group 2, CX; Group 3, HC; and Group 4, QC. Each agent was applied with 5 minutes of manual pressure followed by a standard field compression dressing. Hetastarch (500 mL) was infused over 30 minutes. Hemodynamic parameters were recorded over 180 minutes. Primary endpoints included rebleed and death. Results:  CX reduced rebleeding to 0% (p 
ISSN:1069-6563
1553-2712
DOI:10.1111/j.1553-2712.2007.00009.x