Page 56 - Journal of Special Operations Medicine - Fall 2015

Table 1 Foam Performance Under Special Operations Forces-Relevant Use Conditions*
1-Hour 3-Hour Hemorrhage Rate,
Study Condition Survival, % p Value** Survival, % p Value** g/kg/min p Value** ,†
Field-relevant delivery system 92 .0005 67 .006 0.48 ± 0.41 <.0001
prototype (n = 12)
Operational temperature: 100 .0002 83 .002 0.36 ± 0.06 <.0001
10°C (n = 6)
Operational temperature: 100 .0002 67 .006 0.54 ± 0.26 <.0001
50°C (n = 6)
Accelerated shelf-life study 100 .0002 83 .002 0.49 ± 0.25 <.0001
(n = 6)
Control group (n = 14) 7 — 7 — 3.1 ± 1.2 —
Notes: *Including the fieldable delivery system, shelf-life simulation, and operational temperatures. **Relative to the control group. Foam
†
24
treatment resulted in a survival benefit and reduction in hemorrhage rate relative to the control group at all time points.

but they are within the potential skill set of SOF medical 7. Kelly JF, Ritenour AE, McLaughlin DF, et al. Injury severity
providers. Adoption of the technology on the battlefield and causes of death from Operation Iraqi Freedom and Oper-
should proceed with additional SOF medical provider ation Enduring Freedom: 2003-2004 versus 2006. J Trauma.
2008;64(2 Suppl):S21–26.
input. 8. Morrison JJ, Rasmussen TE. Noncompressible torso hemor-
rhage: a review with contemporary definitions and manage-
Acknowledgments ment strategies. Surg Clinic North Am. 2012;92:843–858.
9. Morrison JJ, Stannard A, Rasmussen TE, et al. Injury pat-
We thank SGM Chris Murphy; COL (Ret) John Hol- tern and mortality of noncompressible torso hemorrhage in
comb, MD; COL Martin Schreiber, MD; CAPT (Ret) UK combat casualties. J Trauma Acute Care Surg. 2013;75:
S263–S268.
Peter Rhee, MD; Dr Bijan Kheirabadi; Dr Mike Dubick; 10. White JM, Stannard A, Burkhardt GE, et al. The epidemiol-
and Dr Jill Sondeen for their comprehensive input into ogy of vascular injury in the wars in Iraq and Afghanistan.
this program, including identification of military re- Ann Surg. 2011;253:1184–1189.
quirements, feedback on device design and experimental 11. Holcomb J, Caruso J, McMullin N, et al. Causes of death in
results, and clinical expertise. We thank Rany Busold US Special Operations Forces in the global war on terrorism:
2001-2004. US Army Med Dept J. 2007;Jan–Mar:24–37.
and Marc Helmick for their help with execution of the 12. Kotwal RS, Montgomery HR, Kotwal BM, et al. Eliminat-
usability work. ing preventable death on the battlefield. Arch Surg. 2011;146:
1350–1358.
Disclosure 13. Duggan M, Rago A, Sharma U, et al. Self-expanding polyure-
thane polymer improves survival in a model of noncompress-
These studies were funded by DARPA and ARO con- ible massive abdominal hemorrhage. J Trauma Acute Care
tracts W911NF-10-C-0089 and W911NF-12-C-0066. Surg. 2013;74:1462–1467.
14. Holcomb JB, Pusateri AE, Harris RA, et al. Effect of dry fi-
brin sealant dressings versus gauze packing on blood loss in
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44 Journal of Special Operations Medicine Volume 15, Edition 3/Fall 2015