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LTC John Holcomb, MC, USA; Martin MacPhee, PhD; LTC Stephen Hetz, MC, USA; LTC Richard Harris, VC, USA; CPT Anthony Pusateri, MS, USA; COL John Hess, MC, USA

Arch Surg. 1998;133:32-35.

Objective  To determine if a dry fibrin sealant dressing (DFSD) will provide superior hemostasis when compared with regular gauze in a ballistic injury animal model.

Design  A nonsurvival randomized goat study.

Setting  A federal biomedical research institute.

Subjects  Eighteen anesthetized Angora goats.

Interventions  Uncontrolled hemorrhage was induced by a complex ballistic extremity injury. Control of hemorrhage was achieved by applying and holding pressure with the DFSD or regular gauze for 2 minutes. The dressings were left in place for 1 hour.

Main Outcome Measures  Total blood loss, mean arterial pressure, ballistic injury, and mortality were recorded after 1 hour.

Results  The injuries were equivalent for the 2 groups. No animal mortality was seen. After 1 hour, the mean(±SEM) blood loss was 124±64 mL in the DFSD-treated group and 377±64 mL in the gauze dressings–treated group (P=.01). Twenty minutes after injury, the mean arterial pressure was 95.0 mm Hg (±SEM, ±4.7 mm Hg) in the DFSD-treated group and 70.0±5.0 mm Hg in the gauze dressings–treated group. The difference persisted for the remainder of the study (P=.01).

Conclusion  The DFSD was superior to gauze in decreasing blood loss and maintaining blood pressure while retaining the simplicity of standard dressing application.

From the Departments of Surgery (Drs Holcomb and Hetz) and Clinical Investigation (Drs Harris and Pusateri), William Beaumont Army Medical Center, El Paso, Tex; the American Red Cross Holland Laboratory, Rockville, Md (Dr MacPhee); and the Blood Research Detachment, Walter Reed Army Institute of Research, Washington, DC (Dr Hess).

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