Hemostatic agents

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Types

Plant-Based Oxidized cellulose (OC) and oxidized regenerated cellulose (ORC)
Gelatin-based Purified pork or bovine skin; absorbs 45 times its weight of its initial volume causing hemostasis. Excessive swelling can lead to nerve compression
Collagen-based Derived from tissue; shows cell compatibility, adhesion, growth and migration.
Fibrin-based High concentrations of fibrinogen, thrombin and additional components (clotting factors)
Thrombin-based Directly participate in the coagulation cascade process that promotes and modulates coagulation. Provides a lattice for platelet aggregation and thrombus formation.
Chitin-based Polysaccharide biopolymer produced naturally by algae through fermentation. Also known as chitosan in its deacetylated form. Chitosan has been shown to be more effective that chitin in controlling severe hemorrhage.

Characteristics[1]

Charateristic QuikClot ACS+ HemCon Celox WoundSat Combat Gauze
Hemostatic efficacy + + +++ ++++ ++++
Side effects No No No Yes No
Ready to use Yes Yes Yes Yes Yes
Training requirement + + + +++ ++
Lightweight, durable + +++ +++ + +++
2-year shelf life Yes Yes Yes Yes Yes
Stable in extreme conditions Yes Yes Yes Yes Yes
Cleared by FDA Yes Yes Yes Yes Yes
Biodegradable No No Yes No No
Cost ($) ~30 ~75 ~25 ~30 ~25

Use

  • For compressible hemorrhage not amenable to tourniquet use or as an adjunct to tourniquet removal (if evacuation time is anticipated to be longer than two hours), use Combat Gauze
  • Celox Gauze and ChitoGauze may also be used if Combat Gauze is not available.
  • Hemostatic dressings should be applied with at least 3 minutes of direct pressure.

See Also

References

  1. Kheirabadi B. "Evaluation of Topical Hemostatic Agents for Combat Wound Treatment." The Army Medical Department Journal. April – June 2011. Pages 25-31

Authors

Michael Holtz