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Wiley InterScience | |||||||||
  Academic Emergency MedicineVolume 15 Issue 1, Pages 74 - 81 Published Online: 16 Jan 2008 © 2010 Society for Academic Emergency Medicine Published on behalf of the Society for Academic Emergency Medicine (SAEM)
Abstract | References | Full Text: HTML, PDF (Size: 114K) | Related Articles | Citation Tracking  Basic Investigation An Alternative Hemostatic Dressing: Comparison of CELOX, HemCon, and QuikClot SAM Medical Products funded this study in its entirety, and without restriction. The authors have no personal or professional affiliation with, and have received no personal compensation from, SAM Medical Products. The views expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government. The Chief, Navy Bureau of Medicine and Surgery, Washington, DC, Clinical Investigation Program sponsored this study (CIP #06-061). I am a military service member. This work was prepared as part of my official duties. Title 17 U.S.C. 105 provides that "Copyright protection under this title is not available for any work of the United States Government." Title 17 U.S.C. 101 defines a United States Government work as a work prepared by a military service member or employee of the United States Government as part of that person's official duties. Presented at the Special Operations Medical Association, Annual Conference, Tampa, FL, November 2006 (oral); The IEME/Washington Chapter of the American College of Emergency Physicians, Annual Meeting, Maui, HI, December 2006 (oral); The Government Services Chapter of the American College of Emergency Physicians (GSACEP), Annual Research Competition, Joint Services Symposium, San Antonio, TX, March 2007 (oral)—received best research presentation award; Naval Medical Center Annual Research Competition, Portsmouth, VA, April 2007 (oral)—received best oral presentation and second place in poster presentation; The Fourth Mediterranean Emergency Medicine Congress (MEMC IV), Sorrento, Italy, September 2007 (poster and oral presentation accepted); and the American College of Emergency Physicians Annual Scientific Assembly, Seattle, WA, October 2007 (poster accepted). Copyright © 2008 Blackwell Publishing, Inc KEYWORDS hemostatic dressing • uncontrolled hemorrhage • CELOX • chitosan • zeolite ABSTRACTObjectives: 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 < 0.001), HC to 33% (95% CI = 19.7% to 46.3%, p = 0.038), and QC to 8% (95% CI = 3.3% to 15.7%, p = 0.001), compared to 83% (95% CI = 72.4% to 93.6%) for SD. CX improved survival to 100% compared to SD at 50% (95% CI = 35.9% to 64.2%, p = 0.018). Survival for HC (67%) (95% CI = 53.7% to 80.3%) and QC (92%; 95% CI = 84.3% to 99.7%) did not differ from SD. Conclusions: In this porcine model of uncontrolled hemorrhage, CX improved hemorrhage control and survival. CELOX is a viable alternative for the treatment of severe hemorrhage. Received July 25, 2007; revision received August 29, 2007; accepted August 29, 2007. | 
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