Assessing effectiveness of topical hemostatic chitosan-based agents in experiments

Abstract

Relevance.Persistent profuse external hemorrhage is known to be one of the main causes of death in combat casualties.Intention.To evaluate experimentally the effectiveness of new chitosan-based topical hemostatic agents (THA) in various models of profuse external arterial hemorrhage.Method.New hemostatic chitosan-based agents of Hemohit type in various pharmaceutical dosage forms (Hemohit powder, 20 g per package and Hemohit-applicator [fine chitosan powder Hemohit-A or chitosan granules Hemohit-AG 6 g in the syringe-applicator]) were assessed for effectiveness in the model of profuse external arterial hemorrhage (bevelled laceration of the femoral artery) in 10 large laboratory animals (pigs). Evaluation of the THA effectiveness was performed according to the following parameters: primary hemostasis – stopping of bleeding immediately after application of the 1st THA package and application of a pressure bandage; secondary haemostasis – stopping bleeding immediately after applying the 2nd THA package and applying a pressure bandage, if the 1st THA package is ineffective; final hemostasis – no bleeding within 3 hours of follow-up; absence / resumption of bleeding after the march test; total amount of blood loss during the experiment; survival.Result and their analysis. It was experimentally found that in the case of external profuse arterial hemorrhage the powder and the syringe-applicator provided permanent hemostasis and 100 % animal survival. In two cases out of four, a second package of Hemohit powder was required for the final stop of bleeding. The bleeding stopped due to the formation of an edge thrombus in the area of the vascular wall defect.Conclusion.Hemohit THA can effectively stop arterial bleeding. The effectiveness of applicator with local hemostats can be assessed in the proposed experimental model with a deep narrow wound canal and femoral artery damage.