Pre-hospital Hemorrhagic Control Effectiveness of Axiostat® Dressing Versus Conventional Method in Acute Hemorrhage Due to Trauma.

Accidents and trauma are one of the leading causes of death and disability throughout the world. In developing countries like India where emergency trauma care is still emerging, it accounts for almost 10% of deaths every year. Lack of adequate pre-hospital care and uncontrolled bleeding from the wound site are stated to be the prominent reasons for such deaths. The aim of this study was to evaluate the efficacy of a novel chitosan-based haemostatic dressing, Axiostat® (Axio Biosolutions Private Ltd., Gujarat, India), as a hemorrhage control device in the ambulance setting. A total of 104 patients with bleeding scalp wounds were randomly allocated into two treatment groups while transporting them to the hospital. Patients in Group I were treated with Axiostat® chitosan haemostatic dressing (n = 47), while a conventional cotton gauze dressing was used in Group II (n = 57). A standard procedure was followed to apply the dressing on bleeding wounds and time to achieve haemostasis, the amount of blood loss, the number of patients with haemostasis, the occurrence of rebleeding, and other side effects were noted. The mean age of the patients was 40 years and the majority of patients were male - 73 (70%). Most of the wounds were lacerations with venous bleeding. Haemostasis time was 4.68 ± 1.04 minutes and 18.56 ± 5.04 minutes in the Axiostat® and cotton gauze groups, respectively. The use of Axiostat® significantly reduced the time to haemostasis (p < 0.0001). A significant reduction in blood loss was observed with the application of Axiostat®. Successful haemostasis was achieved in 94% of patients in the Axiostat® group and 74% patients in cotton gauze group, respectively (p < 0.05). Moreover, no side effects, such as tissue loss or rebleeding at time of removal, were seen with the use of Axiostat®, while three patients in the cotton gauze group showed some side effects. Results show that Axiostat® enables rapid haemostasis and can prevent significant blood loss during emergency trauma and accidents. Additionally, it also allows for easier removal from the wound site without leaving any residue, which helps in rendering the wound clean. In conclusion, the study successfully demonstrates the potential of Axiostat® as a first-line intervention in controlling acute haemorrhage in emergency care.