Hydrophobically modified chitosan gauze: a novel topical hemostat

Area of Science:

• Biomaterials Science
• Trauma Medicine
• Surgical Hemostasis

Background:

• Combat Gauze (CG) is the standard hemostatic agent for severe military hemorrhage.
• Hydrophobically modified chitosan (hm-C) exhibits enhanced hemostatic properties over native chitosan.
• This study evaluates hm-C gauze against established hemostatic dressings.

Purpose of the Study:

• To compare the efficacy of hm-C gauze against Combat Gauze (CG) and ChitoGauze (ChG).
• To assess hemostatic performance in a lethal in vivo hemorrhage model.
• To evaluate survival rates, dressing usage, and blood loss.

Main Methods:

• A randomized lethal hemorrhage model using Yorkshire swine.
• Comparison of hm-C gauze, ChitoGauze (ChG), and Combat Gauze (CG).
• Femoral artery puncture model with 30 seconds of free bleeding followed by dressing application and 3-minute compression.

Main Results:

• hm-C gauze achieved 100% survival, outperforming CG (75%) and ChG (75%).
• Total blood loss was significantly lower with hm-C gauze (4.7 mL/kg) compared to CG (13.4 mL/kg) and ChG (12.1 mL/kg).
• Hemostasis duration was longer with hm-C gauze (3 hours) versus CG (2.25 hours).

Conclusions:

• hm-C gauze shows superior performance in a lethal hemorrhage model compared to CG and ChG.
• While trends favored hm-C gauze, statistical significance was not reached for key endpoints.
• Future studies will utilize hypothermic, coagulopathic models to differentiate outcomes in smaller treatment groups.