This one is too easy by half. The fluids are shot into the injuryand contained while it encapsulates the wound itself, haltingbleeding. It is a three hour bridge that is enough to save most.
It certainly surpasses the old pressure bandage.
This will quickly find its way into motor vehicle accidents and therelated paramedic training. In practice, paramedic training isadvancing and improving apace. It is the first stage in recovery andwe are slowly solving the worst cases. It is becoming more and morepossible to survive the event. It will always be touch and go, butthis means that bleeding out after the paramedics arrive is less of arisk.
DARPA FOAM COULDINCREASE SURVIVAL RATE FOR VICTIMS OF INTERNAL HEMORRHAGING
December 10, 2012
Technology developedunder DARPA’s Wound Stasis System program resulted in 72 percentsurvival rate at three hours post-injury in testing
http://www.darpa.mil/NewsEvents/Releases/2012/12/10.aspx
The Department ofDefense’s medical system aspires to a standard known as the “GoldenHour” that dictates that troops wounded on the battlefield aremoved to advanced-level treatment facilities within the first 60minutes of being wounded. In advance of transport, initialbattlefield medical care administered by first responders is oftencritical to injured service members’ survival. In the case ofinternal abdominal injuries and resulting internal hemorrhaging,however, there is currently little that can be done to stanchbleeding before the patients reach necessary treatment facilities;internal wounds cannot be compressed the same way external woundscan, and tourniquets or hemostatic dressings are unsuitable becauseof the need to visualize the injury. The resulting blood loss oftenleads to death from what would otherwise be potentially survivablewounds.
DARPA launched itsWound Stasis System program in 2010 in the hopes of finding atechnological solution that could mitigate damage from internalhemorrhaging. The program sought to identify a biological mechanismthat could discriminate between wounded and healthy tissue, and bindto the wounded tissue. As the program evolved, an even bettersolution emerged: Wound Stasis performer Arsenal Medical, Inc.developed a foam-based product that can control hemorrhaging in apatient’s intact abdominal cavity for at least one hour, based onswine injury model data. The foam is designed to be administered onthe battlefield by a combat medic, and is easily removable by doctorsduring surgical intervention at an appropriate facility, asdemonstrated in testing.
Wound Stasisperformers presented pre-clinical data on the foam treatment at the2012 Annual Meeting of the American Association for the Surgery ofTrauma in Kauai, Hawaii. These data demonstrated the ability ofthe foam to treat severe hemorrhage for up to three hours in a modelof lethal liver injury. During testing, minimally invasiveapplication of the product reduced blood loss six-fold and increasedthe rate of survival at three hours post-injury to 72 percent fromthe eight percent observed in controls.
“Potentially, WoundStasis provides an important addition to our ability to save life andlimb. Getting after these heretofore difficult-to-stabilize, if notuntreatable wounds, expands our options and effectively extends the‘Golden Hour,’” said Maj. Gen. Bill Hix, Director of ConceptDevelopment for the Army Capability Integration Center at Trainingand Doctrine Command. “A capability like this is important in anyoperation, but would prove vital during operations in austere areaswhere military resources and infrastructure are at a premium,” hesaid.
“Wound Stasis hasbeen an exciting program because we were able to move unexpectedlyfrom fundamental research to a pre-clinical proof-of-concept based onthe strength of our findings,” said Brian Holloway, DARPAprogram manager. “According to the U.S. Army Institute of SurgicalResearch, internal hemorrhage is the leading cause of potentiallysurvivable deaths on the battlefield, so the Wound Stasis effortshould ultimately translate into an increased rate of survival amongwarfighters. If testing bears out, the foam technology could affectup to 50 percent of potentially survivable battlefield wounds. Welook forward to working with the U.S. Food and Drug Administration onfuture regulatory submission of this device, and with our partners,the Army Institute of Surgical Research and Special OperationsCommand, on getting this technology to where it’s desperatelyneeded on the front lines.”
The foam is actually apolyurethane polymer that forms inside a patient’s body uponinjection of two liquid phases, a polyol phase and an isocyanatephase, into the abdominal cavity. As the liquids mix, tworeactions are triggered. First, the mixed liquid expands toapproximately 30 times its original volume while conforming to thesurfaces of injured tissue. Second, the liquid transforms intosolid foam capable of providing resistance to intra-abdominal bloodloss. The foam can expand through pooled and clotted blood anddespite the significant hydrostatic force of an active hemorrhage.
In tests, removal ofthe foam took less than one minute following incision by a surgeon.The foam was removed by hand in a single block, with onlyminimal amounts remaining in the abdominal cavity, and with nosignificant adherence of tissue to the foam. Features appearingin relief on the extracted foam showed conformal contact withabdominal tissues and partial encapsulation of the small and largebowels, spleen, and liver. Blood absorption was limited to near thesurface of the foam; the inside of the foam block remained almostuniformly free of blood.
DARPA recently awardeda $15.5 million Phase II contract to Arsenal Medical to continuedevelopment of the treatment system and support regulatorysubmission. DARPA anticipates continuing the Wound Stasis programthrough at least FDA approval of a prototype device.
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