Impact of Extreme Temperatures on Hemostatic Gauze Using Thromboelastography

Area of Science:

• Trauma and Emergency Medicine
• Biomaterials Science
• Hematology

Background:

• Hemorrhage control is critical in austere environments, especially for non-tourniquet amenable wounds.
• Hemostatic gauzes are vital, but their efficacy can be affected by extreme storage temperatures.
• Discoloration of hemostatic gauze has been observed under such conditions.

Purpose of the Study:

• To evaluate the impact of extreme temperature exposure on hemostatic gauze efficacy.
• To compare the performance of Kerlix and QuikClot Combat Gauze after storage at -10°C, 70°C, and 22°C.
• To assess changes in thromboelastography parameters indicating clotting function.

Main Methods:

• In vitro study using blood from 30 healthy adults, diluted to mimic coagulopathy.
• Thromboelastography (TEG) was used to analyze R, K, α angle, and MA parameters.
• Hemostatic gauzes (Kerlix, QuikClot Combat Gauze) were stored for 3 weeks at extreme temperatures (-10°C, 70°C) and room temperature (22°C).

Main Results:

• Diluted blood showed impaired clotting kinetics compared to whole blood.
• Both gauzes shortened clot initiation time (R value) in diluted blood.
• QuikClot Combat Gauze significantly reduced R values compared to Kerlix.
• The ability of hemostatic gauze to initiate clotting (R value reduction) remained consistent across all tested temperatures.

Conclusions:

• Hemostatic gauze retains its in vitro ability to initiate clotting despite prolonged exposure to temperature extremes.
• This finding supports the continued use of hemostatic gauzes in austere environments with variable storage conditions.
• Further research may explore the long-term stability and in vivo performance under similar conditions.