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April 1995

Efficacy of a Fibrin Hemostatic Bandage in Controlling Hemorrhage From Experimental Arterial Injuries

Author Affiliations

From the Letterman Army Institute of Research, Presidio of San Francisco, Calif (Drs Larson, Bowersox, Lim, and Hess), and the Department of Surgery, University of California, San Francisco (Drs Bowersox and Lim). Dr Bowersox is currently affliated with the Madigan Army Medical Center (HSHV-STV), Tacoma, Wash.

Arch Surg. 1995;130(4):420-422. doi:10.1001/archsurg.1995.01430040082018

Objective:  To determine if a pressure dressing containing fibrinogen and thrombin could provide more effective control of arterial hemorrhage than a pressure dressing alone in an animal model of arterial injury.

Design:  Randomized acute (nonsurvival) experiment in swine.

Setting:  Federal biomedical research institute.

Animals:  Six anesthetized Yorkshire swine.

Interventions:  Uncontrolled arterial hemorrhage was induced in anesthetized swine by creating femoral artery lacerations. Hemorrhage was controlled by a gauze bandage containing fibrinogen and thrombin, applied with 1 minute of 3.5-kg pressure. The dressings were left in place for 1 hour after the pressure was removed. The contralateral limbs received identical treatment with plain gauze dressings.

Main Outcome Measures:  Total blood loss, mean arterial pressure, and mortality were measured after 1 hour.

Results:  After 1 hour, blood loss in the fibrin bandage group was 123±48 mL, compared with 734±134 mL in the control group (P=.0022). In the group treated with the fibrin bandages, there was no significant decrease in the mean arterial pressure after arterial laceration. In contrast, there was a decrease of 30 mm Hg in the group treated with gauze dressings alone. There was no animal mortality during the study period.

Conclusions:  Bandages containing fibrinogen and thrombin significantly reduced the amount of blood loss and allowed mean arterial pressures to be maintained in animals with uncontrolled hemorrhage from femoral artery lacerations. A hemostatic bandage may be an important adjuvant for controlling severe extremity hemorrhage in the prehospital setting.(Arch Surg. 1995;130:420-422)