Délais de prise en charge allongés et pasnement hémostatiques: Danger

Safety of the long-term application of QuikClot Combat Gauze, ChitoGauze PRO and Celox Gauze in a femoral artery injury model in swine - a preliminary study

Otrocka-Domagała I et Al. Pol J Vet Sci. 2016;19(2):337-43. doi: 10.1515/pjvs-2016-0041.

 

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L'impossibilité d'extraire un comabttant de la zone de combat pour une chirurgie précoce est un problème, notamment si un pansement hémostatique a été posé. Ce travail ancien interpelle.  Dans un modèle de choc hémorragique porcin  le recours à ce type de pansement, que cela soit le kaolin ou le chitosan, peut être responsable de dégâts tissulaires et de complications emboliques.  Le Woundstat, granulés de smectite, avait été interdit d'emploi pour la même raison.

 

The purpose of this study was to examine the safety of the long-term application of QuikClot Combat Gauze, ChitoGauze PRO and Celox Gauze using a swine model. The study was conducted on nine pigs weighing approximately 30 kg, which were randomly divided into three groups. Under deep anesthesia, the pigs underwent complete transverse cutting of the femoral artery in the groin region. Hemostatic dressings were left in the wound for 24 hours. The animals were euthanized 24 hours after dressing application. In each group, macroscopic and microscopic severe changes and shock symptoms were observed in the lungs, liver, kidneys and heart. Fibrino-gaseous embolic material was found in the pulmonary artery of each group and in the lung vessels of the animals from the ChitoGauze PRO and Celox Gauze groups. In conclusion, the long-term application of the evaluated hemostatic dressings has the risk of coagulopathy and reaching the progressive stage of shock. The residues from the hemostatic dressings can ingress into the systemic circulation, thereby increasing the risk of embolus formation.

 

 

Because of these harmful effects, the evaluated hemostatic dressings are not appropriate for long-term use. Future studies are needed on the consequences of the long-term application of these hemostatic agents.

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