Traumatic injury is a major global health problem, accounting for approximately 1 in 10 deaths worldwide. Hemorrhagic shock accounts for 30% to 40% of injury-associated deaths (2/3 of those patients surviving to reach the hospital) and is the leading cause of preventable and early in-hospital mortality. Excessive blood loss is an infrequent but important complication of both elective and emergency surgery, increasing the risk of morbidity and mortality and prolonging the duration of hospital stay.
The modified rapid deployment hemostat (mRDH) trauma bandage has been developed and tested during the past several years. The mRDH has a unique mechanism of action involving vasoconstriction, platelet activation, and red blood cell activation and is effective in the absence of clotting factors or platelets. The mRDH bandage has shown hemostatic efficacy in patients with severe visceral injuries and hepatic rupture.
The following case studies illustrate the effective use of the mRDH bandage in a variety of settings, as follows: (1) application of the mRDH to control severe hemorrhage from an improvised explosive device-induced lower extremity injury in Iraq and (2) the mRDH terminates bleeding from a penetrating groin wound allowing safe neurosurgical intervention while avoiding a groin exploration.
From the Division of Trauma, Critical Care, and Acute Care Surgery (M.A.S.), Oregon Health and Science University, Portland, Oregon; and Division of Trauma, Emergency Surgery and Surgical Critical Care (D.R.K.), Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
Submitted for publication March 28, 2011.
Accepted for publication May 19, 2011.
The manufacturer, Marine Polymer Technologies, Inc., did not participate in the design, data collection, analysis, or manuscript preparation regarding this investigation.
Address for reprints: David R. King, MD, Division of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Boston, MA 02114; email: firstname.lastname@example.org.