Quote:
Originally Posted by Pacer
Swat Surgeon...
Doc
Thanks for the research data on the WoundSatat.
A few posts ago, you note you've got an "empiric" series of pateints in your OR.
What has been your personal experience with Chitosan (Celox)? Especially intruqued with the "Celox -A" prep that comes in a syringe type applicator for use (theoretically) in a puncture type wound with inaccessable vascular involvement. Kinda negates the reservation with a "tampon" completing the disruption of the vessel....IF it works while awaiting your magic hands/dissection, etc.
Again, what has been your experience.
(Dr) Pacer ()
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I would Never put a free powder/granule product down where I could not see it...the risk of embolization of one of these "free" products that could lead to DIC is too much for me to ever attempt it or suggest it.
My use of celox has been limited to the hospital ED where I now work. They stocked it for use in the emergency department as a back-up hemostatic agent for injured patients. After introducing quik-clot (combat gauze and the "tea-bags") to all of the staff, celox was gone and quik-clot was ordered. Did it work, yea, it did, was it a mess, yes. My issue with it was a patient that had it under a huge myo-cutaneos flap had it "washed out" and not all of it was removed and to dig it out to debride it out was a PAIN IN THE BUTT. Natural history of this stuff stayng around???? does it 'de-activate'?
the rules of engagement are different for military vs civilian patients and based on intracorporial use of quik-clot, I'm a believer in the product as are a lot of military practicioners.
I have had people ask me if they could administer celox down a wound track via syringe....What you need is pre-hospital pressure/tourniquet application then a trauma surgeon. In the field, you need a medic that can identify the problem, and use whatever skills and brain power are necessary to get the hemorrhage arrested until casevac, etc to a surgeon......
my experience with 18D's is that they will understand the procedures necessary to make the wound more "cooperative", I have been told stories of them doing what I do: enlarge the wound, get the exposure necessary to better create a solution...let your imagination run with that one.
Celox is a product like other products: they have their followers and believers and most of that comes from stories, 1/2 truths and little personnal experience....I really try to believe none until I use it far beyond what is talked about/written about myself, then I become a fan on a product, I test it in the operative field as well as the pre-operative one....doesn't mean I'm any more qualified to tell anyone anything other than what I have seen with my own eyes and that I have NO financial/personal/ conflict of interest in ANY product I use...too many people out there that can not say the same thing who are some of the proponents of these products
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