Management of External Hemorrhage in Tactical Combat Casualty Care: The Adjunctive Use of XStat? Compressed Hemostatic Sponges. TCCC Guidelines: Change 15-03.
Kyle Sims; F. Bowling, Harold Montgomery, Paul Dituro; Bijan S. Kheirabadi, PhD, Frank Butler, MD
Journal of Special Operations Medicine
J Spec Oper Med. 2016 Spring;16(1):19-28
Management of External Hemorrhage in Tactical Combat Casualty Care: Chitosan-Based Hemostatic Gauze Dressings. TCCC Guidelines ? Change 13-05.
Brad L. Bennett, PhD, NREMT-P; Lanny F. Littlejohn, MD; Bijan S. Kheirabadi, PhD;
Frank K. Butler, MD; Russ S. Kotwal, MD; Michael A. Dubick, PhD; Jeffrey A. Bailey, MD
Journal of Special Operations Medicine
J Spec Oper Med. 2014 Fall;14(3):40-57
Comparison of novel hemostatic gauzes to QuikClot Combat Gauze in a standardized swine model of uncontrolled hemorrhage.
Jason M. Rall, PhD, Jennifer M. Cox, BS, Adam G. Songer, MD, Ramon F. Cestero, MD,
and James D. Ross, PhD
Journal of Trauma Acute Care Surgery
J Trauma Acute Care Surg. 2013; 75(2 Suppl 2):S150-6.
Hemostasis in a noncompressible hemorrhage model: An end-user evaluation of hemostatic agents in a proximal arterial injury.
Steven Satterly, MD, Daniel Nelson, DO, Nathan Zwintscher, MD, Morohunranti Oguntoye, MD, Wayne Causey, MD, Bryan Theis, BS, Raywin Huang, PhD, Mohamad Haque, MD,
Matthew Martin, MD, J Gerald Bickett EMT, and Robert M. Rush Jr, MD
Journal of Surgical Education
J Surg Educ. 2013;70(2):206-11.
Advanced hemostatic dressings are not superior to gauze for care under fire scenarios.
Jennifer M. Watters, MD, Philbert Y. Van, MD, Gregory J. Hamilton, BS, Chitra Sambasivan, MD, Jerome A. Differding, MPH, and Martin A. Schreiber, MD
Journal of TRAUMA Injury, Infection, and Critical Care
J Trauma 2011;70:1413-18.
Comparison of two packable hemostatic Gauze dressings in a porcine hemorrhage model.
Richard Bruce Schwartz MD, Bradford Zahner Reynolds MD, Stephen A. Shiver MD, E. Brooke Lerner PhD, Eric Mark Greenfield DO, Ricaurte A. Solis DO, Nicholas A. Kimpel DO, Phillip L. Coule MD & John G. McManus MD
Prehospital Emergency Care
Prehosp Emerg Care 2011;15:477-482
A synthesis of studies performed to evaluate the efficacy of the various hemostatic agents available at the point of injury show that they all perform equally.
Novel hemostatic devices (QuikClot Combat Gauze, QuikClot Combat Gauze XL, Celox Trauma Gauze, Celox Gauze, or HemCon ChitoGauze) perform at least as well as the current Committee on Tactical Combat Casualty Care standard for point-of-injury hemorrhage control. Despite their different compositions and sizes, the lack of clear superiority of any agent suggests that contemporary hemostatic dressing technology has potentially reached a plateau for efficacy.
There is no significant difference in hemostasis between hemostatic bandages for proximal arterial hemorrhage. Hemostasis significantly improves between 2 and 4 minutes using direct pressure and hemostatic agents. Prior medical training leads to 20% greater efficacy when using hemostatic dressings.
ChitoGauze and CombatGauze appear to be equally efficacious in their hemostatic properties, as demonstrated in a porcine hemorrhage model.
XStat (a non-absorbable, expandable, hemostatic sponge) is a new product recently approved by the FDA as a hemostatic adjunct to aid in the control of bleeding from junctional wounds in the groin or axilla. XStat is a new option for the control of external hemorrhage from junctional bleeding sites that are not adequately addressed by tourniquets, Combat gauze, Celox gauze, Chitogauze, Combat Ready Clamp, Junctional Emergency Treatment Tool, or the SAM Junctional Tourniquet.