Comparison of combat gauze and TraumaStat in two severe groin injury models

Background: Fabric-like hemostatic dressings offer promise for hemorrhage control in noncompressible areas, especially given their similarity in form to standard gauze currently in use. Recently, two such products, Combat Gauze (CBG) and TraumaStat (TMS), were introduced. Their performance is evaluated in two vascular injury models. Materials and Methods: The dressings were evaluated in anesthetized Yorkshire pigs, hemorrhaged by full transection of the femoral vasculature with 2 min free bleeding period (CBG = 6, TMS = 6) or by 4 mm femoral arterial puncture with 45 s free bleeding period (CBG = 8, TMS = 8). After injury, dressings were applied, followed by 5 min of manual compression and then 500 mL resuscitation fluid infused over 30 min. Vital signs, blood pressure, and blood loss were recorded throughout the 3-h experiment. Bleeding control was the primary outcome. Results: All animals had similar pretreatment mean arterial pressure (MAP) (∼36.5 mmHg); pretreatment blood loss following injury was similar for both dressing groups in the two models [24% ± 8% estimated blood volume (EBV) 2 min after transection and 17% ± 4% EBV 45 s after puncture. Incidence of post-treatment bleeding, primarily occurring after release of manual compression or restoration of blood pressure, was more frequent in the puncture model (17% with both CBG and TMS) than the transection model (57% with CBG versus 75% with TMS). Post-treatment blood loss not controlled by the dressing was 19% ± 22% and 31% ± 17% EBV, for CBG and TMS, respectively. Survival rate was 100% for both dressings in the transection model, and was 88% for CBG and 50% for TMS in the puncture model. Conclusions: These findings indicated that CBG and TMS were similarly effective in improving hemostasis. These two fabric-like dressings showed easy application and removal, leaving a clean wound for surgical repair.