HEMOSTATIC DRESSINGS

Use: Stop Massive External Bleeding Due to Trauma

 

 

Despite all the advances in trauma care and personal protective equipment such as body armor, hemorrhage continues to be the leading cause of preventable death for both civilian and war combat trauma victims.1, 2 

 

Topical hemostatic agents may be used to control hemorrhage occurring in sites not amenable to tourniquet placement and which cannot be controlled by direct pressure alone. Ideally, the dressing should be lightweight, easy to store, and able to be rapidly applied to a hemorrhaging wound. It should be conformable to the wound, allowing the hemostatic agent to reach areas of injury which are difficult to access with direct pressure (i.e. deep groin wounds). The dressing should cause minimal local tissue destruction, be easily removable from the wound, and not contain particles which can spread systemically. Finally, the dressing must not be washed away by rapid bleeding from high-flow blood profusion.  "Nustat" hemostatic dressings is the ideal dressing and now available.  Nustat is a Silica-based (also known as the glass effect) fibers and regenerated cellulose fibers contribute synergistically with individual properties for accelerated clot formation.  NuStat is a single-use hemostatic wound dressing applied externally and used for packing open wounds.  Hemostasis with "Nustat" can be achieved with proper training and mechanical compression to control bleeding in laceration, punctures, abrasions and incisions.

 

When choosing a hemostatic dressing you should consider economic benefits, type of hemostasis you prefer, the amount of time required for direct pressure to be effective, the storability, the rapid application ability and the functionality of the product.  It is also important to remain cognizant of the advantages and disadvantages of this rapidly evolving and growing area for hospitals and pre-hospital care.

 

It is for these reasons I have endorse "Nustat" hemostatic dressings.  The perfect hemostatic dressing does not exist but I have found that “Nustat” hemostatic dressings by Beeken Biomedical come very close to perfection.  It is effective, durable and is less expensive than the leading brands.  Once you feel, see and use the product you will fall in love with it justifying the replacement of your traditional gauze to "Nustat" hemostatic dressings.

 

"Nustat" Comparison with Other Product Review 

 

HemCon:

HemCon dressing (Hemorrhage Control Technologies, Portland, OR), is composed of chitosan (Shrimp Shell components) , a substance derived from arthropod skeletons. Chitosan dressings are thought to function by mechanically sealing the wound and adhering to surrounding tissue. 

The disadvantage of the HemCon dressing is that it is relatively non- conformable and difficult to pack into deeper wounds

 

WoundStat:

WoundStat was an FDA-approved mineral-based agent consisting of granular smectite, nonmetallic clay. When the granules were exposed to blood they absorbed water, swelled, and formed a clay paste with strong adhesiveness to the surrounding tissue. 

 The granules were also shown to enter the circulatory system and cause thrombosis in distal organs.9  Because of these potentially serious side effects, the U.S. Army announced in April 2009 that WoundStat would no longer be used by their medical personnel. 

 

Combat GauzeTM: 

Combat GauzeTM  is a 3”x4 yard long roll of nonwoven gauze impregnated with kaolin (soft white clay). Combat Gauze has all the advantages of normal gauze (easy application, flexible, large coverage area, and easily removable) with the additional advantage of hemostatic function from the kaolin. It does set the normal clotting cascade. The disadvantage of the Combat Gauze is the time required of direct pressure to be effective.  This is not feasible in care under fire situations.  It is also worth mentioning that kaolin can wash out of the gauze due to heavy bleeding.  This is why they recommend removing the gauze and replacing it with a new one if bleeding does not stop, which goes against medical training that you do not remove gauze once applied you continue to add to the gauze that is already in place.  It is also an expensive product.

 

Celox™

CeloxTM granules are actually very high surface area flakes. When they come in contact with blood, Celox™ swells, gels, and sticks together to make a gel like clot, without generating any heat. Celox™ does not set off the normal clotting cascade, it only clots the blood it comes directly into contact with.  It is made of a propriety composition which contains chitosan (Shrimp Shell components).  The disadvantage of the Celox is it can become flakey to use, expensive and non absorbable.

 

NuStat™

Nustat is a silica-based fibers (Glass Fiber Components) that activates the platelets, amplification of the intrinsic coagulation cascade, (sets off the normal clotting cascade), and red blood cell agglutination on the regenerated cellulose fibers. 

The disadvantages are minimum there forth making this product superior as stated above, however, you want to avoid directly inhaling the dressing due to the silica based fibers.  

 

Future Use:

Silica-Based Fibers (Glass Fiber Components) is considered a third generation for wound care with future advantages in burn patients and diabetes.

 

Fraunhofer-Gesellschaft has said wound dressing made of silica gel fibers will soon help to heal difficult wounds caused by burns or diabetes. The dressing forms a supporting matrix for newly growing skin cells and is fully absorbed by the body during the healing process.

 

In Germany alone, about three million – mostly elderly – patients suffer from poorly healing large-area wounds caused by complaints such as diabetes, burns or bedsores. The wounds can be treated with conventional collagen dressings or polylactic acid dressings, but the success rate is not as good as it should be.

 

A new type of dressing made of silica gel fibers, developed by scientists at the Fraunhofer Institute for Silicate Research ISC in Würzburg, shall solve the problem. This novel dressing has many advantages: it is shape-stable, pH-neutral and 100 percent bioresorbable. Once applied it remains in the body, where it gradually degrades without leaving any residues. What’s more, the fiber fleece provides the healthy cells around the edges of the wound with the structure they additionally need for a proper supply of growth-supporting nutrients. To prevent any infection, treatment of the wound must be absolutely sterile.

 

“As only the outer bandage needs to be changed, the risk of contaminating the wound is low,” explains Dr. Jörn Probst of the ISC. And thanks to the supporting matrix for the cells, the chances of a scar-free natural closure of the wound are very good.

The fibers are produced by means of wet-chemical material synthesis, a sol-gel process in which a transparent, honey-like gel is produced from tetraethoxysilane (TEOS), ethanol and water in a multi-stage, acidically catalyzed synthesis process. The gel is processed in a spinning tower.

 

“We press it through fine nozzles at constant temperatures and humidity levels,” explains Walther Glaubitt, the inventor of the silica gel fibers. “This produces fine endless threads which are collected on a traversing table and spun in a specific pattern to produce a roughly A4-sized multi-layer textile web.” The dressings are then cut, packed and sterilized. Dr. Jörn Probst and Dipl.-Ing. Walther Glaubitt will receive the Joseph von Fraunhofer Prize 2008 for developing the biocompatible dressing.

A partner to support the development and market the dressing has already been found: Bayer Innovation GmbH BIG, a wholly owned subsidiary of Bayer AG. “We anticipate that hospitals will start to use the silica gel wound dressing in 2011,” states Iwer Baecker, project manager at Bayer Innovation GmbH. And that is by no means the end of the story.

The scientists plan to integrate active substances such as antibiotics or painkillers in the dressing to improve and accelerate the healing process.

 

 

Story Source:

The above story is based on materials provided by Fraunhofer-Gesellschaft. Note: Materials may be edited for content and length.

Fraunhofer-Gesellschaft. "Rapid Wound Healing With Dressing Made Of Silica Gel Fibers." ScienceDaily. ScienceDaily, 3 June 2008. <www.sciencedaily.com/releases/2008/05/080529112634.htm>.

 

 

1. Kelly JF, Ritenour AE, McLaughlin DF, et al. Injury severity and causes of death from Operation Iraqi Freedom and Operation Enduring Free- dom: 2003–2004 versus 2006. J Trauma. 2008;64:S21–S26.

 

2. Cirillo VJ. Two faces of death: fatalities from disease and combat in America’s principal wars, 1775 to present. Perspect Biol Med. 2008;51: 121–133. 

 

9. Bheirabadi BS, Mace JE, Terrazas IB, et al. Safety evaluation of new hemostatic agents, smectite granules, and kaolin-coated gauze in a vascular injury wound model in swine. J Trauma. 2010;68:269-278. 10