Bleeding Disorder Clinical Trial
Official title:
Haydarpaşa Numune Education and Research Hospital
The objective of this study was to prospectively compare effectiveness of Ankaferd Blood
Stopper (ABS) with dry sponges in cessation of bleeding in adult trauma cases with external
bleeding due to extremity lacerations.
Methods: The study was conducted on patients with bleeding associated with extremity
lacerations. All consecutive patients presented to the emergency department of the
high-volume training hospital in Istanbul were recruited within the study period
This study was planned as a prospective randomized study. After local ethics committee
approval, all consecutive patients admitted to the Emergency Department of the Haydarpasa
Numune Training & Research Hospital due to extremity lacerations between October 1st and
October 11th 2018 were recruited. The longest duration for wound healing, infection
follow-up, and suture removal was 12 days. Therefore, the study was completed in a total of
23 days after suture removal of the last case.
ABS which was approved in 2017 by the Ministry of Health, is being used routinely in the
management of the patients with traumatic bleeding in the emergency department of the
hospital. Nurses working in treatment areas of the department were trained for this
prospective study. They were trained to apply compression of approximately 3-kg weight after
irrigation with saline in patients with active bleeding who met inclusion criteria. Bleeding
was controlled in every minute and data were collected. Traditional methods such as primary
suturing were performed in patients whose bleeding did not stop within 10 minutes. Patients
whose bleeding was stopped were monitored for half an hour for bleeding recurrence.
The patients were divided into two groups; ones treated by ABS soaked wet compresses (group
I) and ones treated by dry sponge compresses (group II). Demographic data, systemic disease
history, drugs used, injury mechanism, habits etc. of the patients enrolled in the study were
recorded into data collection form.
Forty commercially prepared ABS-soaked wet sterile sponges and 40 dry sponges of 2.5x7 cm
were randomly numbered and placed in a box in the study area. Random numbers table was used
to generate the sequence of enumeration of the sponges. Any given patient was treated with
the next sponge with the smallest number in the box and data sheets contained the number of
the sponge with which the patient's bleeding was intervened. Therefore, allocation
concealment was accomplished for the study purposes.
In both groups, lacerations that did not stop bleeding within 10 minutes and lacerations with
recurred bleeding within the half-hour follow-up period were repaired by the primary
suturing. Lacerations were sutured at the end of follow-up period in other patients. Daily
dressing was recommended to the patients at discharge, and they were invited for a follow-up
visit 3 days later. They were followed-up for wound infection. Suture removal date was
recorded in data collection form.
Statistical analysis was conducted by using the MedCalc Statistical Software version 12.7.7
(MedCalc Software bvba, Ostend, Belgium; http://www.medcalc.org; 2013). Descriptive
statistics were used to define continuous variables in this study (mean, standard deviation,
range, and median). Mann Whitney U test was used to compare two independent and abnormally
distributed groups. Chi-square test was performed to compare categorical variables, or
Fisher's Exact test was performed where appropriate or required. Statistical significance
level was determined as p<0.05.
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