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The journal of trauma and acute care surgery, 2012
Noncompressible hemorrhage is the leading cause of preventable death caused by hemorrhage on the ... more Noncompressible hemorrhage is the leading cause of preventable death caused by hemorrhage on the battlefield. Currently, there are no hemostatic agents with the ability to control noncompressible hemorrhage. A wound stasis dressing based upon rapidly expanding cellulose minisponges (MS) was developed and tested in a lethal noncompressible model in swine, by fully transecting subclavian artery and vein. MS were compared with conventional hemostasis dressings, Combat Gauze (CG), in a randomized comparison. Sixteen 40-kg swine underwent transection of the subclavian artery and vein through a 4.5-cm aperture. After 30-second free bleeding, randomly selected MS or CG (n = 8 per group) were administered by an independent medical officer. The wound cavity was filled with either MS + no external pressure or one CG + one KERLIX gauze with 3 minutes of external pressure. One reapplication was allowed for CG. Mean arterial pressure was maintained at 60 mm Hg with 500-mL Hextend and lactated Ringer's solution intravenously administered up to a maximum of 10-L until study termination at 1 hour. Mean pretreatment blood loss was similar for MS (719 mL) and CG (702 mL). Primary end points, namely, hemostasis at 4 minutes (MS, 75%; CG, 25%; p = 0.13), hemostasis at 60 minutes (MS, 100%; CG, 25%; p = 0.007), and survival at 60 minutes (MS, 100%; CG, 37.5%; p = 0.026), were improved with MS as were secondary end points, namely, total blood loss (MS, 118 mL; CG 1,242 mL; p = 0.021) and length of application time (MS, 25 seconds; CG, 420 seconds; p = 0.004). The use of MS is a novel approach for the rapid, simple treatment of severe noncompressible hemorrhage, which provided statistically significant improvement in hemostasis and survival 60 minutes after injury and a large reduction in blood loss, resuscitation fluid requirement, and medic treatment time compared with conventional hemorrhage control dressings in a swine model.
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Laser tissue welding is a sutureless method of wound closure that has been used successfully in n... more Laser tissue welding is a sutureless method of wound closure that has been used successfully in nerve, skin, and arterial anastomoses. We welded an elastin-based biomaterial that elicits minimal foreign body reaction to the intimal surface of porcine aorta. The aorta was stained with indocyanine green dye to efficiently absorb the 808 nm diode laser light. Laser welding with a pulsed diode laser thermally confines heating to stained portion of tissue, minimizing adjacent tissue damage. Laser welds of stained aorta to biomaterial were attempted by sandwiching the samples between glass slides and applying pressure ranging from 4 - 20 N/cm2 for 5 ms pulse durations and 83 mJ/mm2 radiant exposure. Welds were successful for pressure above 5 N/cm2. Transmission measurements of stained aorta were made using radiant exposures of 6 - 129 mJ/mm2 using pulse durations of 0.5 - 5 ms. Transmission increases and reaches a maximum of 80 - 85% with successive pulses for radiant exposure greater than 26 mJ/mm2 for a spot size of 9 mm2 and 13 mJ/mm2 for a spot size of 36 mm2.
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Lasers in Medical Science, 1997
Laser tissue welding is a sutureless method of wound closure that has been used successfully in n... more Laser tissue welding is a sutureless method of wound closure that has been used successfully in nerve, skin and arterial anastomoses. An elastin-based biomaterial patch was welded to the intimai surface of porcine aorta in the present study. The aorta was stained with indocyanine green dye to efficiently absorb the 808 nm diode laser light. Laser welding with a pulsed diode laser thermally confines heating to the stained portion of tissue, minimizing adjacent tissue damage. Laser welds of stained aorta to biomaterial were attempted by sandwiching the samples between glass slides and applying pressures ranging from 4 to 20 N cm-2 for 5 ms pulse durations and 83 mJ mm-2 radiant exposure. Bleaching of the indocyanine green by as much as 85% was observed after exposure laser irradiation. Finally, successful welds required 5 N cm-2 of pressure between the elastin biomaterial and aorta.
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The journal of trauma and acute care surgery, 2012
Noncompressible hemorrhage is the leading cause of preventable death caused by hemorrhage on the ... more Noncompressible hemorrhage is the leading cause of preventable death caused by hemorrhage on the battlefield. Currently, there are no hemostatic agents with the ability to control noncompressible hemorrhage. A wound stasis dressing based upon rapidly expanding cellulose minisponges (MS) was developed and tested in a lethal noncompressible model in swine, by fully transecting subclavian artery and vein. MS were compared with conventional hemostasis dressings, Combat Gauze (CG), in a randomized comparison. Sixteen 40-kg swine underwent transection of the subclavian artery and vein through a 4.5-cm aperture. After 30-second free bleeding, randomly selected MS or CG (n = 8 per group) were administered by an independent medical officer. The wound cavity was filled with either MS + no external pressure or one CG + one KERLIX gauze with 3 minutes of external pressure. One reapplication was allowed for CG. Mean arterial pressure was maintained at 60 mm Hg with 500-mL Hextend and lactated Ringer's solution intravenously administered up to a maximum of 10-L until study termination at 1 hour. Mean pretreatment blood loss was similar for MS (719 mL) and CG (702 mL). Primary end points, namely, hemostasis at 4 minutes (MS, 75%; CG, 25%; p = 0.13), hemostasis at 60 minutes (MS, 100%; CG, 25%; p = 0.007), and survival at 60 minutes (MS, 100%; CG, 37.5%; p = 0.026), were improved with MS as were secondary end points, namely, total blood loss (MS, 118 mL; CG 1,242 mL; p = 0.021) and length of application time (MS, 25 seconds; CG, 420 seconds; p = 0.004). The use of MS is a novel approach for the rapid, simple treatment of severe noncompressible hemorrhage, which provided statistically significant improvement in hemostasis and survival 60 minutes after injury and a large reduction in blood loss, resuscitation fluid requirement, and medic treatment time compared with conventional hemorrhage control dressings in a swine model.
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Laser tissue welding is a sutureless method of wound closure that has been used successfully in n... more Laser tissue welding is a sutureless method of wound closure that has been used successfully in nerve, skin, and arterial anastomoses. We welded an elastin-based biomaterial that elicits minimal foreign body reaction to the intimal surface of porcine aorta. The aorta was stained with indocyanine green dye to efficiently absorb the 808 nm diode laser light. Laser welding with a pulsed diode laser thermally confines heating to stained portion of tissue, minimizing adjacent tissue damage. Laser welds of stained aorta to biomaterial were attempted by sandwiching the samples between glass slides and applying pressure ranging from 4 - 20 N/cm2 for 5 ms pulse durations and 83 mJ/mm2 radiant exposure. Welds were successful for pressure above 5 N/cm2. Transmission measurements of stained aorta were made using radiant exposures of 6 - 129 mJ/mm2 using pulse durations of 0.5 - 5 ms. Transmission increases and reaches a maximum of 80 - 85% with successive pulses for radiant exposure greater than 26 mJ/mm2 for a spot size of 9 mm2 and 13 mJ/mm2 for a spot size of 36 mm2.
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Bookmarks Related papers MentionsView impact
Lasers in Medical Science, 1997
Laser tissue welding is a sutureless method of wound closure that has been used successfully in n... more Laser tissue welding is a sutureless method of wound closure that has been used successfully in nerve, skin and arterial anastomoses. An elastin-based biomaterial patch was welded to the intimai surface of porcine aorta in the present study. The aorta was stained with indocyanine green dye to efficiently absorb the 808 nm diode laser light. Laser welding with a pulsed diode laser thermally confines heating to the stained portion of tissue, minimizing adjacent tissue damage. Laser welds of stained aorta to biomaterial were attempted by sandwiching the samples between glass slides and applying pressures ranging from 4 to 20 N cm-2 for 5 ms pulse durations and 83 mJ mm-2 radiant exposure. Bleaching of the indocyanine green by as much as 85% was observed after exposure laser irradiation. Finally, successful welds required 5 N cm-2 of pressure between the elastin biomaterial and aorta.
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Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact