WoundStat Update

After only recently announcing that Z-Medica's Combat Gauze, and another hemostatic product called WoundStat were the new standard for Tactical Combat Casualty Care, the Army has pulled one of them following the 2008 Special Operations Medical Association conference.
WoundStat was found to have a severe risk of causing occlusive thrombosis (clotting leading to blockage), deeper inside the body than simply at the wound site. The Army has issued directives for all WoundStat to be turned in, and it's use to be discontinued pending further testing.

I'll post two bits that were passed along to me via email regarding this.
First, the FRAGO that went out regarding discontinuation of WoundStat:

FROM
CDRUSAMMA FT DETRICK MD//MCMR-MMO-SO//

***PRIORITY***MESSAGE NOT RELEASED

****************UNCLASSIFIED****************

SUBJ: T0B-1218-002
NEW SOLDIER HEMOSTATIC DRESSINS / WOUNDSTAT / MEDICAL INFORMATION


REFERENCE: ALARACT 239/2008, NEW SOLDIER HEMOSTATIC DRESSINGS

1. THIS FRAGO DIRECTS TEMPORARY CESSATION OF USE OF WOUNDSTAT™ (WS) BY 68W
COMBAT MEDICS AND ALL OTHER PROVIDERS DUE TO NEWLY IDENTIFIED SAFETY CONCERNS
ABOUT THIS PRODUCT, PENDING FURTHER EVALUATION.

2. WOUNDSTAT™ WILL BE TURNED IN TO THE MEDICAL SUPPLY SYSTEM IMMEDIATELY.
UNIT SUPPLY PERSONNEL WILL TURN -IN WOUNDSTAT™ TO THEIR SUPPORTING MEDICAL
SUPPLY SUPPORT ACTIVITY (SSA). THE ARMY MEDICAL SSA WILL REVIEW TRANSACTION
REGISTERS AND COMPLETE 100% CONTACT WITH UNITS ISSUED WS TO ENSURE TURN-IN
OF PRODUCT. ARCENT WILL SUBMIT THE TOTAL NUMBER OF WS ISSUED AND COLLECTED
TO OTSG. THE ARMY MEDICAL SSA WILL HOLD WS UNTIL FURTHER NOTICE OR UNTIL DISPOSITION
INSTRUCTIONS ARE RECEIVED FROM OTSG.

3. DATA FROM THE US ARMY INSTITUTE OF SURGICAL RESEARCH (USAISR) SHOW THAT
WS IS ASSOCIATED WITH A HIGH INCIDENCE OF BLOOD VESSEL THROMBOSIS AND DAMAGE
TO THE VESSEL WALL. COMBAT GAUZE AND PLAIN KERLIX WERE NOT ASSOCIATED WITH
SIMILAR FINDINGS. USE OF COMBAT GAUZE IS SAFE, ACCORDING TO CURRENT STUDIES,
AND DISTRIBUTION AND USE SHOULD CONTINUE.

4. MEDICAL PERSONNEL MUST LOCATE AND EXAMINE ALL CASUALTIES PREVIOUSLY TREATED
WITH WS TO VERIFY ADEQUATE LIMB PERFUSION, IF WS WAS USED TO TREAT EXTREMITY
WOUNDS.

5. EXPIRATION DATE CANNOT BE DETERMINED.

And, an email originating from Frank Butler (whose name should be immediately familiar if you've been doing your homework):

-----Original Message-----
From: Butler, Frank K., CTR [mailto:[redacted]@med.navy.mil]
Sent: Wednesday, December 24, 2008 12:35 PM
Subject: WoundStat Message

Forwarded FYI.

The attached message reflects safety concerns about WoundStat presented by
Dr. Bijan Kheirabadi from the U.S. Army Institute of Surgical Research at
the recent Special Operations Medical Association conference.

Dr. Kheirabadi observed that 7 of 8 animals on whom WoundStat was used in a
carotid artery bleeding model developed occlusive thrombosis and had no
blood flow 2 hours after suturing of the wound.

The implications of this study for both WoundStat and hemostatic agent
testing in general are currently under review.

Note that WoundStat currently serves as the "Last Resort" of medics' options
to stop life-threatening external hemorrhage. TCCC guidelines call for
tourniquets, Combat Gauze, and WoundStat in that order. When used
appropriately, WoundStat is the medic's last intervention to stop a casualty
from bleeding to death from external hemorrhage in a location not amenable
to tourniquet use.

V/R -

Frank

Frank K. Butler, Jr. M.D.
CAPT MC USN (RET)
Chairman
Committee on Tactical Combat Casualty Care

The summary of Dr. Kheirabadi's presentation should be up on the SOMA site sometime in the near future.
Further testing and independent evaluations will undoubtedly happen, and will either put the final nails in WoundStat's coffin, or possibly out it as safe for use with an improved protocol.
Until I hear differently however, WoundStat is off my list. Fortunately, I dont own any, but was thinking about adding some given its 100% effectiveness in testing. As of now, however, WoundStat is a no-go.
Sticking to Z-Medica (QuickClot) Combat Gauze, and QuickClot Sponges.

A Lesson on Combat Knives, in Two Parts: The MOD XSF-1, and the Mil-Tac CS1

The Mil-Tac Combat Survival 1 (Left) and the Blackhawk XSF-1 (Right)

There is, in the knife community, an undue fascination with “fighting” and “combat” knives. Lots of collectors, enthusiasts, and makers specialize in these types of blades. Some of them are fine people, but most with an interest in, or god save us an opinion on, such knives lack the weight of need or experience to lend their ideas validity. Yet it is often this lot who have their voice raised above those of the truly experienced and it is their cacophony which drives a large part of the "tactical" knife world. Not because they are right, but often because they have, if nothing else, immense buying power.
However, there remain voices and talents in the industry who, on the weight of their background or the strength of their products, have every right and reason to speak up. Not that they always do, some of these talents seem to prefer letting their products do the talking, and keep their voices low. Some are out-spoken, and on the vocal forefront of the industry, but have earned their place there. In either case it is to these talents that people of an experienced need and background go for cutlery. They do so trusting that what they are buying is not hype, is not a “name”, is in fact nothing but a well designed, well executed performance tool.
These opposing forces are not in balance however. The demand for knives to suit the enthusiast market is much higher than for knives to actually be used, particularly in the “tactical” field. There is money to be made from the fancy, the different, the new and shiny. Hype and gadgetry have made more people money than reliability and proven forms...

[Read The Rest: Click Here]

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Foundations

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