Abstract
Background
This work sought to (1) establish a reliable gunshot model of junctional femoral artery
rupture in swine that accurately simulates field rescue conditions and (2) use the
gunshot model to compare the efficacy and ease of application of zeolite nanometer
hemostatic gauze with other hemostatic materials.
Methods
Thirty-six healthy landrace swine (body weight 50 ± 5 kg) were randomly divided into
three groups which were treated with Combat Gauze (CG), FeiChuang hemostatic gauze
(FG), or standard medical gauze (SG). A gunshot model of femoral artery hemorrhage
in landrace swine was used with portable ultrasound to accurately position the wound.
After the shooting, when mean arterial pressure of swine decreased by at least 30%
for 10 s, wounds were pressed with standard packing (39 g) of gauze materials for
3 min to stop bleeding, then bandaged with pressure. Blood samples were taken 15 min
before injury, then 10 min, 30 min, and 60 min after injury to determine hemodynamic,
coagulation, and arterial blood gas indexes. Wound temperatures were taken at 5 min,
10 min, 30 min, and 60 min after injury, and survival times were recorded. The volume
of blood loss and survival time were used to evaluate hemostatic effect, whereas the
fill time, wound temperature, and physiological indexes were used to evaluate the
safety and operation of the product.
Results
The CG (11.15 ± 3.09 mL/kg) and FG (12.19 ± 3.5 mL/kg) groups had significantly less
blood loss than the SG group (16.8 ± 5.14 mL/kg) (P = 0.04; P = 0.039, respectively). After gauze packing, bleeding in CG (5.85 ± 1.17 mL/kg) and
FG (5.37 ± 0.93 mL/kg) groups remained significantly lower than that of the SG group
(6.93 ± 1.03 mL/kg) (P = 0.011; P = 0.003, respectively). Wound temperature rose with time for all groups (P < 0.001). The wound temperatures in the FG group and the CG group were significantly
higher than that of the SG group (P = 004 and 0.009, respectively). Survival rates and times were not significantly different
among the three groups, although the FG group had the longest average survival time
(standard deviation [SD] 204.8 s), compared with the SG group (SD 177.8 s) and CG
(SD 187.5 s) groups. No significant differences in hemodynamics, blood gas, and coagulation
were observed among the three groups.
Conclusions
The gunshot model of junctional femoral arterial hemorrhage guided by ultrasound had
high accuracy for femoral arterial rupture by bullet wound and provided consistent
and reproducible field-simulation conditions for comparison of hemostatic materials.
FeiChuang zeolite hemostatic gauze effectively controlled bleeding as well as combat
gauze, without excessive heat as found in other zeolite-based products. However, improvements
to application technique, such as a packing device, are needed to improve operating
time.
Keywords
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Article info
Publication history
Published online: March 03, 2021
Accepted:
December 16,
2020
Received in revised form:
November 11,
2020
Received:
May 27,
2020
Identification
Copyright
© 2020 Published by Elsevier Inc.
