Page 54 - Journal of Special Operations Medicine - Winter 2014

hold (T0), at 5 minutes, 10 minutes, and every 10 min- Figure 8 NuStat during 60-minute observation window.
utes thereafter, until study termination at 60 minutes
(T60). A minimum MAP during hemorrhage period was
also recorded to ensure no statistical differences between
groups. The dressing was visually evaluated for immedi-
ate hemostasis, defined as no visible blood leaving the
wound cavity, as well as for continued hemostasis for
the duration of the test period.

At 60 minutes, the dressing was evaluated for hemosta-
sis (Figures 6–8). Range of motion (ROM) testing was
conducted on the subjects, involving three each of flex-
ion and extension and three rotational movements. The
dressing was again evaluated for continued hemostasis
with ROM. Dressing was then removed and ease of re-
moval was evaluated on a 1-to-5 scale, where 1 = very
easy to remove and 5 = very difficult to remove. Hemo- End Points
stasis upon removal was evaluated. Study termination Primary end points for this study included hemorrhage
vital signs were recorded to include HR, MAP, oxygen control defined as yes or no at T0 and T60 after release of
saturation level, and temperature. At this time, 20mL of compression and rebleeding during study. Secondary end
sodium pentobarbital was administered via central line. points were total blood loss after application of dressing
Animal heart sounds were evaluated. as assessed by the difference between the dry weight and
the wet weight of the dressing after 60 minutes; additional
Figure 6 Validation of injury post 60-minute observation blood loss during application; length of application time;
period. blood absorbed by dressing, fluids needed, excluding
baseline and Hextend bolus; and hemostasis with ROM.

Statistical Analysis
All statistical analyses were performed using Kaleida
Graph version 4.5 (Synergy Software; http://www.synergy
.com/wordpress_650164087/). Statistical significance was
assessed using an α level of .05. Descriptive statistics
were determined for each outcome measure within gauze
type to examine differences in various outcome measures
between NS and CG. Given the small sample size, the
Berger binomial two-sided Fisher exact test was used to
evaluate the binary data and Wilcoxon paired t-test was
used to evaluate the continuous data.

Results
Figure 7 Combat Gauze during 60-minute observation
window. There were no baseline differences between the two
groups for vital signs, weight, vessel size, cavity size, or
baseline laboratory findings (Figure 9, Table 1). Due to
multiple complications and inability to meet baseline cri-
teria, one animal in the CG group was excluded, result-
ing in seven animals treated with CG and eight with NS.
Immediate hemostasis was achieved in four animals in
the CG group and eight animals in the NS group, which
produced a statistically significant result (p = .0475)
( Table 2). Additionally, a statistically significant differ-
ence was discovered for postapplication blood loss (0 ± 0
vs 1,218.3 ± 807.7; p = .385), quantity of NS needed to
maintain MAP (174 ± 214 vs 842 ± 1291; p = .0042), and
dressing application time (31 ± 7 vs 38 ± 2; p = .0093)
(Table 3). All the animals in both groups survived.

44 Journal of Special Operations Medicine Volume 14, Edition 4/Winter 2014