Development and validation of a model of severe abdominal blast injury: characterization and hemostatic response

To establish a stable porcine model of severe abdominal blast injury with massive hemorrhage and evaluate a novel hemostatic material (novel hydrogel bioadhesive) versus traditional gelatin for emergency management.

A severe abdominal blast injury was induced in Bama miniature pigs (n = 18) using a 5 g JH-14 charge (3.5 cm standoff). The experimental animals were randomly divided into two cohorts: the blast injury model preparation cohort (n = 6) and the hemostatic material cohort (n = 12). The latter cohort was further randomized into control (gauze), hemostatic gelatin, and novel hemostatic material groups (n = 4/group). Hemostatic efficacy was assessed via vital signs, blood loss, survival, biomarkers, and histopathology.

The model produced full-thickness abdominal wall laceration (mean area: 16.24 ± 0.53 cm²), severe liver injury, and massive hemorrhage (497.8 ± 45.70 g blood loss), with systemic hypothermia and shock. Post-injury hematology showed reduced RBC, WBC, PLT, Hb, and ALB, while AST, ALT, and LDH surged. Both hemostatic materials reduced blood loss, extended survival, and partially stabilized vital signs, though Hb continued declining. Biochemical markers (ALT, LDH) partially recovered. Inflammatory markers (PCT, CRP, etc.) increased post-injury but remained unchanged post-treatment. Histopathology confirmed liver necrosis and inflammation, with partial recovery at 2 weeks; no apparent difference was observed between materials.

The porcine model effectively simulates severe abdominal blast trauma. Both hemostatic materials achieved rapid local hemostasis but were limited by persistent occult bleeding and systemic complications. Future strategies should integrate optimized hemostasis with systemic resuscitation to enhance emergency outcomes.