Page 37 - JSOM Fall 2019

FIGURE 7 Adapted from McKee JL, Kirkpatrick AW, Bennett FIGURE 9 Provided by Innovative Trauma Care. Available at
BL, et al. Worldwide case reports using the iTClamp for external https://www.innovativetraumacare.com. Used with permission.
hemorrhage control. J Spec Oper Med. 2018;18(3):39–44.

FIGURE 8 Adapted from McKee JL, Kirkpatrick AW, Bennett
BL, et al. Worldwide case reports using the iTClamp for external The mechanism is easily visualized on the CT-angiography im-
hemorrhage control. J Spec Oper Med. 2018;18(3):39–44. ages in a study reported in the Journal of Trauma in which
cadavers were reperfused with water. Because there were no
47
coagulation factors present, the study demonstrated that the
mechanical forces involved were exclusively responsible for
hemorrhage control. The iTClamp’s unique design makes it
ideal for application to the head and neck (https://www.you
tube.com/watch?v=6AzCtPAOBTY).
Although the iTClamp is available in only one size, the de-
vice can be used in series for wounds longer than 5 cm. Plac-
ing multiple iTClamps end to end can create the appropriate
seal on longer wounds (Figure 10) (https://www.youtube.com/
watch?v=8b8E2JQTMhc).

FIGURE 10 Provided by Innovative Trauma Care. Available at
https://www.innovativetraumacare.com. Used with permission.

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a variety of laceration applications. An animal study, case
reports, 4,6,7,41–43 and usability studies 49,50 demonstrate iTClamp
safety including the absence of tissue damage even after forc-
ible removal of the device from the patient after application.
51
Studies across all skill levels of medical providers and nonmed-
ical first responders validate the ability of all users to control Additionally, larger wounds should be packed with a
bleeding rapidly with the iTClamp. 43,49,52 CoTCCC-recommended hemostatic dressing prior to use to
decrease cavity volume and reduce hemorrhage. For wounds
1. What is the mechanism of action of the iTClamp? where the skin is tighter, such as the scalp, the device closure
The iTClamp is the first in a new class of hemorrhage control can be adjusted by the user so that less skin is required to seal
devices that uses the hydrostatic backpressure of a hematoma the wound. The unique mechanism of action of the iTClamp
inside a wound cavity to generate pressure and produce a he- can replace direct pressure and compliments existing hemo-
mostatic effect on the injured vessel. The device establishes static adjuncts recommended by CoTCCC. It is not intended
a fixed fluid-tight seal through wound edge approximation. to replace but rather to augment all current TCCC approved
This seal creates a hematoma that tamponades injured ves- hemorrhage control devices.
sels via hydrostatic pressure to replace direct pressure on the
injured vessel (Figure 9) (https://www.youtube.com/watch?v= 2. How does the iTClamp compare with other methods of
iVO-QRTGM7U). Once the hydrostatic pressure in the wound hemorrhage control in the head and neck region?
cavity equalizes with the internal pressure of the injured vessel, There are no similar devices to which direct comparisons
it creates a hemostatic environment independent of coagula- can be made. Comparisons with other classes of hemostatic
tion factors. devices need to be interpreted with the understanding that

iTClamp Mechanical Wound Closure Device | 35