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Preliminary risk and benefit analysis of the intracorporeal use of Combat Gauze„§
Author(s) -
Kheirabadi Bijan Shams,
Hardin Mark O,
Terrazas Irasema B,
Valdez Krystal K,
Hanson Margaret A,
Dubick Michael A
Publication year - 2011
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.25.1_supplement.998.3
Subject(s) - hemostat , medicine , surgery , saline , anesthesia
Kaolin‐coated gauze (Combat Gauze, CG) is primarily used on the battlefield for treating external bleeding, but occasionally it is also used off‐label in combat hospitals to treat internal bleeding. Using swine, this study examined the safety and benefits of such intra‐corporeal use. Anesthetized, instrumented pigs (~40 kg) were subjected to severe liver injuries and bleeding was controlled by packing wounds w/CG (n=4) or regular gauze (RG, n=3) and wrapping the liver w/lap sponges. Pigs were recovered overnight, incisions reopened the next day, and sponges and CG or RG were gently removed w/saline irrigation. Liver lobes were then removed for histopathology. Packing hepatic wounds w/CG or RG stopped bleeding and normalized pigs' vital signs. No significant blood/clots were found in the peritoneum at the 2 nd operation. RG and CG tightly adhered to damaged tissues and their removal disrupted hemostatic clots causing rebleeding that would require repacking. Histologically, infarction and congestive necrosis were seen along edges of wounds (~2 mm deep) in both groups, likely caused by physical compression and/or compromised blood supply. CG is an effective hemostat for damage control operations with no apparent detrimental effects. However, necessary removal of this non absorbable agent from liver wounds may cause significant rebleeding that requires repacking and delays definitive care. Funded by USAMRMC.