Page 84 - JSOM Fall 2021

TABLE 6 Weighted Scoring of Chest Seals Tested for Both Adherence and Vent/Valve Function
Total Score
(Mean of Scores) Score Outcome Description n = Citation
Asherman Chest Seal
3 Adherence to dry swine skin 12 17
1 Adherence to blood soiled swine skin 12 17
2 Adherence to human skin with simulated wounds 10 13
1.833
1 Adherence against horizontal forces at ambient temperatures 3* 14
1 Adherence against vertical forces at ambient temperatures 3* 14
3 Valve efficacy 12 17
Bolin Chest Seal
3 Adherence to dry swine skin 12 17
3 Adherence to blood soiled swine skin 12 17
3 Adherence to human skin with simulated wounds 36 13
2 Adherence against horizontal forces at varying temperatures 36* 14
2.5
2 Adherence against vertical forces at varying temperatures 36* 14
3 Valve efficacy preventing tension pneumothorax 12 17
3 Valve efficacy preventing tension pneumothorax 8 19
1 Chest seal efficacy at combined adherence and vent capability with bleeding wound 4 16
Hyfin Vent Chest Seals

3 Adherence against horizontal forces at varying temperatures 36* 14
3 Adherence against vertical forces at varying temperatures 36* 14
2.75
3 Vent efficacy preventing tension pneumothorax 8 18
2 Chest seal efficacy at combined adherence and vent capability with bleeding wound 6 16
Russell Chest Seal

2 Adherence to human skin with simulated wounds 8 13
3 Adherence against horizontal forces at varying temperatures 36* 14
2.75
3 Adherence against vertical forces at varying temperatures 36* 14
3 Chest seal efficacy at combined adherence and vent capability with bleeding wound 6 16
SAM Chest Seal with Valve

2 Adherence to human skin with simulated wounds 8 13
3 Adherence against horizontal forces at varying temperatures 36* 14
2.2 3 Adherence against vertical forces at varying temperatures 36* 14
3 Vent efficacy preventing tension pneumothorax 8 18
1 Chest seal efficacy at combined adherence and vent capability with bleeding wound 4 16
Sentinel Chest Seal

1 Adherence to human skin with simulated wounds 15 13
1 Adherence against horizontal forces at ambient temperatures 3* 14
1.8 1 Adherence against vertical forces at ambient temperatures 3* 14
3 Vent efficacy preventing tension pneumothorax 8 18
3 Chest seal efficacy at combined adherence and vent capability with bleeding wound 6 16
*Sample size not clearly stated by author; estimates or averages provided.

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1 cm of the simulated wound 30–40 minutes after application. Kit (H&H Medical Corporation, www.hhmedcorp.com). Su-
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After recording the initial results, Supinksi et al. readhered the pinksi et al. found no statistically significant difference in adher-
device after a simulated “burping” and once again evaluated ence between the Asherman Chest Seal, Bolin Chest Seal, Halo
for percent adherence or damage to the dressing. In 2016, Ar- Chest Seal (Curaplex, www.curaplex.com), Hyfin Chest Seal,
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naud et al. tested for chest seal adherence when challenged by Russell Chest Seal, and SAM Chest Seal With Valve. However,
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horizontal and vertical forces. Resistance to horizontal forces Supinksi et al. concluded the “SAM [with valve] and Bolin Chest
was assessed by measuring the percentage of the chest seal still Seal performed better,” due to lower rates of adhesion failure
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adhered after a manual rubbing force was applied to the edges within 1 cm of the wound. Supinksi et al. further concluded
of the chest seal. A novel dual syringe system with a quantifi- that neither the Sentinel Chest Seal or the H&H Wound Seal Kit
able vertical pulling force was used to assess each device’s resis- should be kept in military inventory based on their statistically
tance to vertical forces. The force needed to separate the device significant poor performance. In 2008, Arnaud et al. reported
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from the skin, up to 20 mL of syringe vacuum, was recorded. that on dry skin, the Asherman and Bolin Chest Seal performed
similarly, but the Bolin Chest Sealperformed statistically better
Supinksi et al. reported a statistically significant improvement on blood-soiled skin. In 2016, Arnaud et al. reported no sig-
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in adhesion of the SAM Chest Seal With Valve and Bolin Chest nificant difference in adhesion between the FastBreathe Tho-
Seal (H&H Medical Corporation, www.hhmedcorp.com) as racic Seal, Hyfin Vent Chest Seal, Russell Chest Seal, and SAM
compared to the Sentinel Chest Seal and the H&H Wound Seal Chest Seal With Valve at all temperatures. 14
82 | JSOM Volume 21, Edition 3 / Fall 2021