A special report on the chitosan-based hemostatic dressing: experience in current combat operations.

Ian Wedmore, John G. McManus, Anthony E. Pusateri, John B. Holcomb

Research output: Contribution to journalArticle

353 Citations (Scopus)

Abstract

BACKGROUND: Hemorrhage remains a leading cause of death in both civilian and military trauma patients. The HemCon chitosan-based hemostatic dressing is approved by the US Food and Drug Administration (FDA) for hemorrhage control. Animal data have shown the HemCon dressing to reduce hemorrhage and improve survival. The purpose of this article is to report preliminary results of the hemostatic efficacy of the HemCon dressing used in the prehospital setting on combat casualties. METHODS: A request for case information on use of HemCon dressings in Operation Iraqi Freedom and Operation Enduring Freedom was sent to deployed Special Forces combat medics, physicians, and physician assistants. RESULTS: Sixty-eight uses of the HemCon dressing were reported and reviewed by two US Army physicians. Four of the 68 cases were determined duplicative resulting in a total of 64 combat uses. Dressings were utilized externally on the chest, groin, buttock, and abdomen in 25 cases; on extremities in 35 cases; and on neck or facial wounds in 4 cases. In 66% of cases, dressings were utilized following gauze failure and were 100% successful. In 62 (97%) of the cases, the use of the HemCon dressing resulted in cessation of bleeding or improvement in hemostasis. There were two reported dressing failures that occurred with blind application of bandages up into large cavitational injuries. Dressings were reported to be most useful on areas where tourniquets could not be applied to control bleeding. The dressings were reported to be most difficult to use in extremity injuries where they could not be placed easily onto or into the wounds. No complications or adverse events were reported. CONCLUSION: This report on the field use of the HemCon dressing by medics suggests that it is a useful hemostatic dressing for prehospital combat casualties and supports further study to confirm efficacy.

Original languageEnglish (US)
Pages (from-to)655-658
Number of pages4
JournalThe Journal of trauma.
Volume60
Issue number3
DOIs
StatePublished - Mar 1 2006

Fingerprint

Chitosan
Hemostatics
Bandages
Hemorrhage
Wounds and Injuries
2003-2011 Iraq War
Extremities
Afghan Campaign 2001-
Physicians
Physician Assistants
Tourniquets
Buttocks
Groin
United States Food and Drug Administration
Hemostasis
Abdomen
Cause of Death
Neck
Thorax

Keywords

  • Chitosan
  • HemCon
  • Hemorrhage control
  • Hemostatic dressing
  • Military

ASJC Scopus subject areas

  • Surgery

Cite this

A special report on the chitosan-based hemostatic dressing : experience in current combat operations. / Wedmore, Ian; McManus, John G.; Pusateri, Anthony E.; Holcomb, John B.

In: The Journal of trauma., Vol. 60, No. 3, 01.03.2006, p. 655-658.

Research output: Contribution to journalArticle

Wedmore, Ian ; McManus, John G. ; Pusateri, Anthony E. ; Holcomb, John B. / A special report on the chitosan-based hemostatic dressing : experience in current combat operations. In: The Journal of trauma. 2006 ; Vol. 60, No. 3. pp. 655-658.
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abstract = "BACKGROUND: Hemorrhage remains a leading cause of death in both civilian and military trauma patients. The HemCon chitosan-based hemostatic dressing is approved by the US Food and Drug Administration (FDA) for hemorrhage control. Animal data have shown the HemCon dressing to reduce hemorrhage and improve survival. The purpose of this article is to report preliminary results of the hemostatic efficacy of the HemCon dressing used in the prehospital setting on combat casualties. METHODS: A request for case information on use of HemCon dressings in Operation Iraqi Freedom and Operation Enduring Freedom was sent to deployed Special Forces combat medics, physicians, and physician assistants. RESULTS: Sixty-eight uses of the HemCon dressing were reported and reviewed by two US Army physicians. Four of the 68 cases were determined duplicative resulting in a total of 64 combat uses. Dressings were utilized externally on the chest, groin, buttock, and abdomen in 25 cases; on extremities in 35 cases; and on neck or facial wounds in 4 cases. In 66{\%} of cases, dressings were utilized following gauze failure and were 100{\%} successful. In 62 (97{\%}) of the cases, the use of the HemCon dressing resulted in cessation of bleeding or improvement in hemostasis. There were two reported dressing failures that occurred with blind application of bandages up into large cavitational injuries. Dressings were reported to be most useful on areas where tourniquets could not be applied to control bleeding. The dressings were reported to be most difficult to use in extremity injuries where they could not be placed easily onto or into the wounds. No complications or adverse events were reported. CONCLUSION: This report on the field use of the HemCon dressing by medics suggests that it is a useful hemostatic dressing for prehospital combat casualties and supports further study to confirm efficacy.",
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