A special report on the chitosan-based hemostatic dressing: Experience in current combat operations
A special report on the chitosan-based hemostatic dressing: Experience in current combat operations
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DOI：
10.1097/01.ta.0000199392.91772.44
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发表时间：
2006-03-01
影响因子：
--
通讯作者：
Holcomb, JB
中科院分区：
文献类型：
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作者：
Wedmore, I;McManus, JG;Holcomb, JB
背景：出血仍然是平民和军事创伤患者的主要死亡原因。Hem-Con壳聚糖止血敷料获得美国食品和药物管理局(FDA)的批准，用于控制出血。动物数据表明，HemCon敷料可以减少出血，提高存活率。本文的目的是报告在战伤伤员院前环境中使用hemCon敷料止血效果的初步结果。方法：向部署的特种部队战斗医务人员、医生和医生助理发送关于在伊拉克自由行动和持久自由行动中使用hemCon敷料的病例信息。结果：两名美国陆军医生报告和审查了68例hemCon敷料的使用情况。在68起案件中，有4起被确定为重复案件，导致共有作战用途。胸、腹股沟、臀部、腹部外用敷料25例，四肢敷料35例，颈部或面部创面敷料4例。在66%的病例中，纱布失败后使用了敷料，并且100%成功。在62例(97%)病例中，使用hemCon敷料后止血或止血效果改善。据报道，有两例敷料失败是由于盲目使用绷带造成大的空洞损伤。据报道，在无法使用止血带止血的区域，敷料最有用。据报道，这种敷料最难用于四肢损伤，因为它们不能轻易地放在伤口上或伤口内。没有并发症或不良事件的报道。结论：这份关于医疗人员现场使用hemCon敷料的报告表明，对于院前战斗伤员来说，该敷料是一种有用的止血敷料，并支持进一步的研究以证实其有效性。
Background: Hemorrhage remains a leading cause of death in both civilian and military trauma patients. The Hem-Con 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 dffficult 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.