Use of a modified chitosan dressing in a hypothermic Coagulopathic grade V liver injury model

被引：20

作者：

Bochicchio, Grant ^{[1
]}

Kilbourne, Michael ^{[2
]}

Kuehn, Reed ^{[2
]}

Keledjian, Kaspar ^{[1
]}

Hess, John ^{[1
]}

Scalea, Thomas ^{[1
]}

机构：

[1] Univ Maryland, Dept Surg, Baltimore, MD 21201 USA

[2] Walter Reed Army Med Ctr, Washington, DC 20307 USA

来源：

AMERICAN JOURNAL OF SURGERY | 2009年 / 198卷 / 05期

关键词：

Chitosan; Hemorrhage; Advance hemostasis; DAMAGE CONTROL SURGERY; FIBRIN SEALANT DRESSINGS; BLOOD-LOSS; RESUSCITATION VOLUME; PERIHEPATIC PACKING; HEMORRHAGE CONTROL; HEMOSTATIC AGENTS; TRAUMA; SWINE; MORTALITY;

D O I：

10.1016/j.amjsurg.2009.07.028

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

BACKGROUND: Exsanguination from hepatic trauma is exacerbated by the lethal triad of acidosis, coagulopathy, and hypothermia. We evaluated the application of a modified chitosan dressing in a hypothermic coagulopathic model of grade V liver injury. METHODS: Subject swine underwent induced hypothermic coagulopathy followed by standardized grade V liver injuries. A modified chitosan dressing was applied and compared with standard packing. RESULTS: Pretreatment temperature, activated clotting time, and blood loss were similar between groups. Post treatment blood loss was significantly less and resuscitation mean arterial pressure were significantly greater in the modified chitosan group (P < .0001 and P < .018, respectively). Mean fluid resuscitative volume was significantly less in the modified chitosan group (P < .0056). Hemostasis was achieved on average 5.2 minutes following modified chitosan and never achieved with standard packing. At 1 hour post injury, all treatment animals survived compared with half of controls. CONCLUSIONS: Modified chitosan dressings provide simple rapid treatment of life-threatening liver injuries. (C) 2009 Elsevier Inc. All rights reserved.

引用

页码：617 / 622

页数：6

共 30 条

[1] Comparison of hemorrhage control agents applied to lethal extremity arterial hemorrhages in swine [J].