Effect of a chitosan-based hemostatic dressing on blood loss and survival in a model of severe venous hemorrhage and hepatic injury in swine

Background: Hemorrhage is a leading cause of death from trauma. An advanced hemostatic dressing could augment available hemostatic methods. We studied the effects of a new chitosan dressing on blood loss, survival, and fluid use after severe hepatic injury in swine. Methods: Swine received chitosan dressings or gauze sponges. Standardized, severe liver injuries were induced. After 30 seconds, dressings were applied and resuscitation initiated. Blood loss, hemostasis, resuscitation volume, and 60-minute survival were quantified. Results: Posttreatment blood loss was reduced (p < 0.01) in the chitosan group (264 mL; 95% confidence interval [CI], 82-852 mL) compared with the gauze group (2,879 mL; 95% CI, 78810,513 mL). Fluid use was reduced (p = 0.03) in the chitosan group (1,793 mL; 95% CI, 749-4,291) compared with the gauze group (6,614 mL; 95% CI, 2,51917,363 mL). Survival was seven of eight and two of even in the chitosan and gauze groups (p = 0.04), respectively. Hemostasis was improved in the chitosan group (p 0.03). Conclusion: A chitosan dressing reduced hemorrhage and improved survival after severe liver injury in swine. Further studies are warranted.