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New high-tech bandages expected to save many lives on warfront

DOHA, Qatar—Military medics will soon carry bandages designed to halt massive blood loss quickly, the first upgrade for treating battlefield wounds since the days of the Roman Empire.

The two kinds of bandages, expected to be approved soon by Defense Secretary Donald Rumsfeld, form either instant scabs or sealants over a wound. Since the Civil War, 20 percent of troops wounded in battle have died before they get to hospitals.

In the next three years, the bandages will likely be found in American ambulances and emergency rooms to help treat the 100,000 trauma deaths that occur annually in the United States. In any war with Iraq, the dressings potentially would allow medics to stabilize casualties for up to three days before treating the more seriously wounded.

A team of medics and research physicians is traveling in the Persian Gulf to explain how the bandages work. They estimate that had the bandages been available during the Vietnam War, as many as 5,000 of the 58,000 Americans killed there would have survived.

"If you look at all deaths on the battlefield, 90 percent result in a pre-hospital environment," said Col. John Holcomb, commander of the U.S. Army Institute of Surgical Research at Fort Sam Houston in Texas. "If you go back and look at the gauze dressings and the tourniquets used, all these (new treatments) represent a revolution in pre-hospital care and a dramatic leap forward."

The Army and the Red Cross started researching the bandages in the early `90s, and their work took on added importance after several U.S. Army Rangers bled to death in a 1993 urban battle in Somalia. That firefight was made famous in the book and movie "Black Hawk Down."

The 4-by-4-inch bandages are as easy to apply as Band-Aids. One uses an adhesive made from a material called chitosan that's found in shrimp shells. The other is made of blood-clotting agents called fibrin that are found in human blood. That's what you see when you look at scabs.

Neither bandage has been tested on humans, but the military says both dressings are safe, and they have been tentatively approved by the Food and Drug Administration. Tests on animals show the bandages stemmed as much as 50 to 85 percent of the blood loss.

With a limited supply, and as war with Iraq draws closer, the FDA allowed the military to offer the bandages to special operations forces who typically handle the most dangerous missions. More than 95 percent of the troops are expected to sign consent forms agreeing to be treated with the bandages, which could be vital for troops often sent to areas where they can't quickly be evacuated to hospitals or aid stations.

"The (special operations) guys are a little bit farther out, they're in a little more austere setting," said Holcomb, who treated some of the wounded after the 1993 Somalia battle.

About 600 of the fibrin dressings arrived in the Gulf on last week. They cost about $1,000 apiece, but they're likely to be much cheaper as production increases.

The chitosan bandages, made by a Portland, Ore., company, cost about $85, but there are not enough yet for the military.

Besides being able to stop blood loss quickly, military doctors say the bandages are more durable than traditional treatments. That's especially critical for wounded troops often transported on makeshift stretchers in the dark and loaded onto helicopters.

"Dressings come off, tourniquets come loose," said Army Lt. Col. Lewis Smith, chief of medical operations at Army Special Operations Command at Fort Bragg.

"These things will stop the bleeding, period."

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(c) 2003, Knight Ridder/Tribune Information Services.

Iraq

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