Arterial Junctional Hemostasis without Compression: Evaluation of Visco-liquid Hemostats in Male Swine✰

Q3 Biochemistry, Genetics and Molecular Biology

Biomaterials and biosystems Pub Date : 2025-04-11 DOI:10.1016/j.bbiosy.2025.100111

Michelle A. Tucci , Joseph D. Lichtenhan , Hamad A. Benghuzzi , Drew A. Hildebrandt

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Abstract

Trimethylpentyl polysilsesquioxane (POSS) gels containing kaolin and chitin promote clotting and stabilize and strengthen thrombi in vitro, and may offer a potential solution for treating non-compressible wounds. This study was designed to determine if the gels could stop bleeding in a junctional arterial hemorrhage model. Anesthetized male swine were instrumented for systemic arterial pressure (MAP) measurement and saline infusion. A femoral artery was punctured (2 × 6 mm), allowed to bleed freely for 45 s, and then either QuikClot gauze bandage (QC; n = 7), POSS-Kaolin (PK) or POSS-Chitin (PC) (40 ml; n = 7/group) applied with no external compression. Blood loss (BL) at 60 min post-treatment was greater in QC (1166±79 ml) than PK (188±74 ml; p < 0.0001) or PC (523±116 ml; p = 0.0001); BL in PC was greater than in PK (p = 0.03). Total BL (180 min) was higher in QC (1210±93 ml) than PK (475±85 ml, p < 0.001) or PC (632±133 ml; p = 0.002) and in PC vs PK (p = 0.008). Time to clot was not different between PK (3 ± 1) or PC (10±3 min), but was longer in QC (44±9 min) than PK or PC (p < 0.0001 vs PK, p < 0.0003 vs PC). MAP fell 40±3 mmHg in QC by 10 min post-injury (p < 0.0003), and remained below control. PC MAP fell 41±5 mmHg, but returned to control, and MAP did not change in PK. POSS in combination with kaolin or chitin provided hemorrhage control and systemic hemodynamic stability without compression. These results support the treatment concept that this new approach to hemostasis can be efficacious in treating non-compressible trauma wounds.

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无压迫的动脉结缔组织止血：粘液止血剂在雄性猪✰中的应用评价

含有高岭土和几丁质的三甲基戊基聚硅氧烷（POSS）凝胶促进体外凝血，稳定和强化血栓，可能为治疗不可压缩性伤口提供潜在的解决方案。本研究旨在确定凝胶是否可以在结膜动脉出血模型中止血。麻醉后的公猪进行全身动脉压（MAP）测量和生理盐水输注。穿刺股动脉（2 × 6mm），让其自由出血45s，然后使用QuikClot纱布包扎(QC；n = 7)， poss -高岭土（PK）或poss -甲壳素（PC） (40 ml；N = 7/组)，无外压。治疗后60min， QC组失血量（1166±79 ml）大于PK组（188±74 ml）；p & lt;0.0001)或PC(523±116 ml；P = 0.0001)；PC组的BL大于PK组（p = 0.03）。QC组总BL（1210±93 ml）高于PK组（475±85 ml）， p <；0.001)或PC(632±133 ml；p = 0.002), PC vs PK （p = 0.008）。PK组（3±1）和PC组（10±3 min）到凝块的时间无显著差异，但QC组（44±9 min）比PK组和PC组(p <；0.0001 vs PK, p <；0.0003 vs PC)。损伤后10 min， QC MAP下降40±3 mmHg (p <；0.0003)，并保持在控制之下。PC MAP下降41±5 mmHg，但恢复到对照组，MAP在PK中没有变化。POSS与高岭土或几丁质联合使用可以控制出血和全身血流动力学稳定，无需压迫。这些结果支持治疗概念，这种新的止血方法可以有效地治疗不可压缩的创伤伤口。

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