1. Improving on Army Field Gauze for Lethal Vascular Injuries: Challenges in Dressing Development J.V. Edwards, D.V. Parikh, P.S. Howley, S.L. Batiste, B.D. Condon
Vision
Bioconjugates
Commercial Development

2. Cotton Chemistry & Bioactive Molecules
Enzymes
Peptides
Carbohydrates
Lipids
Four classes of bioactive molecules
Discuss with regard to cotton wound dressing research
Enzymes are the catalysts of biological systems and have remarkable catalytic power and specificity.
Peptide a subset of proteins. Are smaller than proteins and as a class of molecules have an incredible breadth of activities
Carbohydrates are one of fuur major classes of molecules. Carbohydrates are aldehyde or ketone compounds with mutiple hydroxyls, and they make up most of the organic matter on earth. Cellulose is the most abundant carbohydrate in the bioshpere.
Lipids have a variety of roles: they serve as fuel moelcules, signal molecules, and components of membranes.

3. Lethal Extremity Arterial Hemorrhage
Half of all deaths on the battlefield are caused by uncontolled hemorrhage.
High blood loss also causes, hypothermia, infection and multiple organ failure.
Rapid hemostasis essential for survival and recovery.

4. Clotting Cascade

5. Swine Femoral Artery Assay

6. Swine Femoral Artery Assay

7. Ideal Battlefield Dressing According to USAISR
Able to stop large vessel arterial and venous bleeding within 2 minutes of application when applied to an actively bleeding wound through a pool of blood.
No requirement for mixing and pre-application when applied to an actively bleeding area.
Simplicity of application by wounded victim, buddy, or medic.
Light weight and durable.
Long shelf life in extreme environments.
Safe to use with no risk or injury to tissues or infection.
Inexpensive.

8. Hemostatic Products Quickclot Chitosan Fibrin Sealant
Army Field Dressing
Is there any deployed product capable of stopping or reducing groin arterial bleed-ing and prevent exsanguination that otherwise could not be controlled by the stan-dard gauze dressing?

9. Cotton – Army Field Gauze
Consists of two layers of gauze that wrap densely packed cotton.
Absorbs a large volume of blood
Cotton strands stimulate platelet aggregation and provide a matrix for blood clot formation
Standard dressing for US Military units.

10. QuickClot
A granular mineral zeolite that raplidly absorbs water in an exothermic reaction.
In a wound, the reaction may concen-trate clotting factors and promotes hemo-stasis.

11. Fibrinogen Human fibrinogen, human thrombin
Protein layers are freeze dried on Dexon mesh.
Upon contact with the wound clotting proteins interact and from a fibrin layer. Adheres tightly.

12. Chitosan (Hemcon) Chitosan a derivative of chitin found in shellfish.
Strong tissue ad-hesive properties that seal the wound and stop the bleeding.

13. Hemostatic Activity of Chitosan- Treated Cotton Gauze

14. Chitosan Grafted Nonwoven

15. Chitosan Sponge and Film

16. AFM of Chitosan Film

17. AFM Image of Chitosan Film

18. Comparing Chitosan and Aminized Cotton

19. Synthesis of Aminized Cotton

20. Performance of Dressings in Femoral Artery Assay

21. Results of Comparison

22. Survival Time Comparison

23. Granular Blend of Smectite and a Superabsorbent Nonwoven
Ward, K.R., et al. J Trauma 2007;
63:

24. Where are We to Date Towards Obtaining an Ideal Battlefield Dressing?
Able to stop large vessel arterial and venous bleeding within 2 minutes of application when applied to an actively bleeding wound through a pool of blood? Yes
No requirement for mixing and pre-application when applied to an actively bleeding area?
Simplicity of application by wounded victim, buddy, or medic?
Light weight and durable?
Long shelf life in extreme environments?
Safe to use with no risk or injury to tissues or infection? Yes
Inexpensive?

25. Future Prospects