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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

The Journal of Trauma: Injury, Infection, and Critical Care: January 2003 - Volume 54 - Issue 1 - p 177-182
Original Articles

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.

From the U.S. Army Institute of Surgical Research (A.E.P., L.C., A.T.M., C.W.G.) and Brooke Army Medical Center (R.A.H.), Fort Sam Houston, Texas, and Oregon Medical Laser Center (S.J.M., K.W.G.), Portland, Oregon.

Submitted for publication November 5, 2001.

Accepted for publication January 19, 2002.

This research was funded solely by the U.S. Army Medical Research and Materiel Command.

The opinions or assertions expressed herein are the private views of the authors and are not to be construed as official or as reflecting the views of the U.S. Department of the Army or the U.S. Department of Defense.

Address for reprints: Anthony E. Pusateri, PhD, Library Branch, U.S. Army Institute of Surgical Research, 3400 Rawley East Chambers Avenue, Fort Sam Houston, TX 78234-6315; email:

© 2003 Lippincott Williams & Wilkins, Inc.