260 Impact of Marine Environment on Hemostatic Gauzes: A Simulated Resuscitation Study Using Thromboelastography

Abstract

Military forces render emergency care in marine environments, where care for exsanguination is challenging. The effect of saltwater on the functionality of hemostatic agents is unknown. In this study, we utilized thromboelastography (TEG) to quantify the effect of saltwater on the efficacy of 5 gauze products. Blood from 24 healthy adult males was diluted by 30% with hetastarch to mimic hemodilution. Dry and saltwater-soaked Kerlix™, ChitoGauze®, CombatGauze®, NuStat™, and WoundClot™ were contrasted in the TEG parameters of R (speed of clot initiation), K (clot amplification), A (clot formation rate), and MA (maximum amplitude of clot) using repeated measures ANOVA at the p &lt .05 statistical significance threshold. Compared to untreated dilute blood, R was significantly faster when any dry or wet gauze was added, with the fastest R values for CombatGauze®. K and A findings were mixed. MA was greater than diluted blood for dry hemostatic gauze, but in the wet condition, only CombatGauze® was significantly greater than diluted blood in MA. Gauze products, wet or dry, improved clotting compared to diluted blood. Saltwater exposure did not significantly detract from this benefit. Present findings suggest that CombatGauze® may be the choice hemostatic gauze for maritime environments.