EFFICACY OF A FIBRIN HEMOSTATIC BANDAGE IN CONTROLLING HEMORRHAGE FROM EXPERIMENTAL ARTERIAL INJURIES

Objective: To determine if a pressure dressing containing fibrinogen a nd thrombin could provide more effective control of arterial hemorrhag e 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 York shire swine. Interventions: Uncontrolled arterial hemorrhage was induc ed in anesthetized swine by creating femoral artery lacerations. Hemor rhage was controlled by a gauze bandage containing fibrinogen and thro mbin, applied with 1 minute of 3.5-kg pressure. The dressings were lef t in place for 1 hour after the pressure was removed. The contralatera l limbs received identical treatment with plain gauze dressings. Main Outcome Measures: Total blood loss, mean arterial pressure, and mortal ity were measured after 1 hour. Results: After 1 hour, blood loss in t he 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 ban dages, 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 anim al mortality during the study period. Conclusions: Bandages containing fibrinogen and thrombin significantly reduced the amount of blood los s 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.