Hemostatic agents

Types
Plant-Based Oxidized cellulose (OC) and oxidized regenerated cellulose (ORC)
Gelatin-basedPurified pork or bovine skin; absorbs 45 times its weight of its initial volume causing hemostasis. Excessive swelling can lead to nerve compression
Collagen-basedDerived from tissue; shows cell compatibility, adhesion, growth and migration.
Fibrin-basedHigh concentrations of fibrinogen, thrombin and additional components (clotting factors)
Thrombin-basedDirectly participate in the coagulation cascade process that promotes and modulates coagulation. Provides a lattice for platelet aggregation and thrombus formation.
Chitin-basedPolysaccharide biopolymer produced naturally by algae through fermentation. Also known as chitosan in its deacetylated form. Chitosan has been shown to be more effective that chitin in controlling severe hemorrhage.

Characteristics[1]
Charateristic QuikClot ACS+ HemCon Celox WoundSat Combat Gauze
Hemostatic efficacy+++++++++++++
Side effectsNoNoNoYesNo
Ready to useYesYesYesYesYes
Training requirement++++++++
Lightweight, durable+++++++++++
2-year shelf lifeYesYesYesYesYes
Stable in extreme conditionsYesYesYesYesYes
Cleared by FDAYesYesYesYesYes
BiodegradableNoNoYesNoNo
Cost ($)~30~75~25~30~25

Use
  • For compressible hemorrhage not amenable to tourniquet use or as an adjunct to tourniquet removal (if evacuation time is anticipated to be longer than two hours), use Combat Gauze
  • Celox Gauze and ChitoGauze may also be used if Combat Gauze is not available.
  • Hemostatic dressings should be applied with at least 3 minutes of direct pressure.

See Also

References
  1. Kheirabadi B. "Evaluation of Topical Hemostatic Agents for Combat Wound Treatment." The Army Medical Department Journal. April – June 2011. Pages 25-31
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