Comparison of two packable hemostatic gauze dressings in a porcine hemorrhage model

Background. Uncontrolled hemorrhage remains the primary cause of preventable battlefield mortality and a significant cause of domestic civilian mortality. Rapid hemorrhage control is crucial for survival. ChitoGauze and Combat Gauze are commercially available products marketed for rapid hemorrhage control. These products were selected because they are packable gauze that work via differing mechanisms of action (tissue adhesion versus procoagulant). Objective. To compare the effectiveness of ChitoGauze and Combat Gauze in controlling arterial hemorrhage in a swine model. Methods. Fourteen swine were studied. Following inguinal dissection and after achieving minimum hemodynamic parameters (mean arterial pressure [MAP] ≥70 mmHg), a femoral arterial injury was created using a 6-mm vascular punch. Free bleeding was allowed for 45 seconds, and then the wound was packed alternatively with ChitoGauze or Combat Gauze. Direct pressure was applied to the wound for 2 minutes, followed by a three-hour monitoring period. Resuscitation fluids were administered to maintain an MAP of ≥65 mmHg. Time to hemostasis, hemodynamic parameters, total blood loss, and amount of resuscitation fluid were recorded every 15 minutes. Data were analyzed using the Wilcoxon rank sum test. Histologic sections of the vessels were examined using regular and polarized light. Results. No statistically significant differences were found between the groups regarding any measured end point. Data trends, however, favor ChitoGauze over Combat Gauze for time to hemostasis, fluid requirements, and blood loss. There was no evidence of retained foreign material on histologic analysis. Conclusion. ChitoGauze and Combat Gauze appear to be equally efficacious in their hemostatic properties, as demonstrated in a porcine hemorrhage model.