KAOLIN-BASED HEMOSTATIC DRESSING IMPROVES HEMORRHAGE CONTROL FROM A PENETRATING IVC INJURY IN COAGULOPATHIC SWINE.

Background: Retrohepatic Vena Cava (RIVC) Injuries are often lethal due to challenges in obtaining hemorrhage control. We hypothesized that packing with a new kaolin-based hemostatic dressing (Z-Medica, Control + (R)) would improve hemorrhage control from a penetrating RIVC injury compared to packing with standard laparotomy sponges alone. Methods: Twelve male Yorkshire pigs received a 25% exchange transfusion of blood for refrigerated normal saline to induce a hypothermic coagulopathy. A laparotomy was performed and a standardized 1.5cm injury to the RIVC was created which was followed by temporary abdominal closure and a period of uncontrolled hemorrhage. When the mean arterial pressure reached 70% of baseline, demonstrating hemorrhagic shock, the abdomen was re-entered and the injury was treated with perihepatic packing using standard laparotomy sponges (L; n=6) or a new kaolin-based hemostatic dressing (K; n=6). Animals were then resuscitated for 6 hours with crystalloid solution. The two groups were compared using the Wilcoxon rank sum test and Fisher exact test. A p0.05). In the laparotomy sponge group, 5 of 6 pigs survived the entire study period while all 6 pigs treated with kaolin-based D2 hemostatic dressings survived. Importantly, there was significantly less blood loss after packing with the new hemostatic kaolin-based dressing compared to packing with laparotomy sponge (651mL+/-180 vs 1073mL+/-342; p

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