The Use of Traumagel for Hemorrhage Control and Tourniquet Removal: A Case Series of Traumatic Extremity Injuries.

Hemorrhage remains the leading cause of preventable death in combat and tactical operations, with exsanguinating hemorrhage accounting for approximately 90% of potentially survivable battlefield fatalities. In operational environments where evacuation to definitive care may be delayed, effective point-of-injury hemorrhage control becomes essential for mission success and force preservation. While tourniquets are proven to be effective in tactical casualty care and are standard gear for Special Operations Forces, their prolonged application carries the risk of additional tissue trauma and potential nerve injury. This report presents three use cases demonstrating the tactical application of Traumagel as an adjunct hemostatic agent alongside tourniquet application, achieving hemorrhage control and enabling tourniquet removal without rebleeding. These cases illustrate the potential utility of combination hemostatic approaches in Special Operations medicine, where rapid, effective bleeding control must be achieved with minimal logistical burden, maximum reliability, and in the face of often long transit times.