Efficacy of a fibrin hemostatic bandage in controlling hemorrhage from experimental arterial injuries
M. J. Larson, J. C. Bowersox, R. C. Lim Jr and J. R. Hess
Letterman Army Institute of Research, Presidio of San Francisco, Calif, USA.
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.
