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Journal of Trauma-Injury Infection & Critical Care:
Original Articles

Effect of a Chitosan-Based Hemostatic Dressing on Blood Loss and Survival in a Model of Severe Venous Hemorrhage and Hepatic Injury in Swine

Pusateri, Anthony E. PhD; McCarthy, Simon J. PhD; Gregory, Kenton W. MD; Harris, Richard A. DVM, MS; Cardenas, Luis; McManus, Albert T. PhD; Goodwin, Cleon W. Jr., MD

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Abstract

Background : Hemorrhage is a leading cause of death from trauma. An advanced hemostatic dressing could augment available hemostatic methods. We studied the effects of a new chitosan dressing on blood loss, survival, and fluid use after severe hepatic injury in swine.

Methods : Swine received chitosan dressings or gauze sponges. Standardized, severe liver injuries were induced. After 30 seconds, dressings were applied and resuscitation initiated. Blood loss, hemostasis, resuscitation volume, and 60-minute survival were quantified.

Results : Posttreatment blood loss was reduced (p < 0.01) in the chitosan group (264 mL; 95% confidence interval [CI], 82-852 mL) compared with the gauze group (2,879 mL; 95% CI, 788-10,513 mL). Fluid use was reduced (p = 0.03) in the chitosan group (1,793 mL; 95% CI, 749-4,291) compared with the gauze group (6,614 mL; 95% CI, 2,519-17,363 mL). Survival was seven of eight and two of even in the chitosan and gauze groups (p = 0.04), respectively. Hemostasis was improved in the chitosan group (p = 0.03).

Conclusion : A chitosan dressing reduced hemorrhage and improved survival after severe liver injury in swine. Further studies are warranted.

© 2003 Lippincott Williams & Wilkins, Inc.

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