VetiGel – Stop Bleeding in Seconds

VetiGel is a plant based polymer formulated to stop bleeding in seconds.

Obviously, stemming blood loss resulting from a wound is an important part of the medics trade so anything new is always worth a look

Vetigel-Stops-Bleeding-In-Seconds-2

VetiGel has been developed by Suneris in the USA and is currently being marketed at vets as they work on human trials.

They say;

Our gel technology is durable and bioresorbable. After the gel has controlled bleeding at the site of injury, the accompanying solidifying agent is applied to solidify the gel and form a long-lasting protective barrier over the wound. Because our plant-based gel technology is biocompatible, it facilitates options and flexibility in follow-up care. Once the gel is secured as a single mass by the solidifying agent, it can either be removed or left in place to safely resorb.

Watch the video below to see how effective it looks.

In addition to the rapid action one of the key selling points is the ease of application and non specialised storage required.

Invented by a 17 year apparently, bloody kids today!

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Pete Arundel
Pete Arundel
January 26, 2015 10:08 am

Any downsides? I’m just wondering if it would complicate any later surgery, for example.
Not that I think it’s a bad idea – given the choice of bleeding out or having surgical complications later I’ll take the later complications, thanks very much . . .

Phil
January 26, 2015 11:46 am

The original Quikclot was a nightmare for surgeons as it was a powder that was to be poured into a wound. Obviously it all had to come out in surgery. So a solid lump of matter is an improvement.

The trick with haemostatic agents is the application. To work they have to be in contact with the blood vessels and that is hard to do in ragged, blast type injuries. Requires a lot of octapus hands and jiggery pokery no matter what type of agent you use.

I suppose the holy grail would be something that could be administered directly into the blood stream and which would work its way to the open vessels and clot immediately. Drama then is access in a shocked patient and the fact that gaining IV access is a perishable skill.

Just remembered we kind if have that, recombinant factor VIIa was used in Helmand. But its a Role 2 Enhanced bit of kit and enormously expensive apparently so was only used on the most serious cases.

Chris
Chris
January 26, 2015 12:02 pm

Phil – never really considered Radweld to stop bleeding – doesn’t it also clog minor vessels? Or does it require air to start setting?

Phil
January 26, 2015 12:14 pm

Radweld might cause a few other dramas if we’re thinking of the same thing!

The recombinant factor vIIa stuff, not sure how it worked. Opinion seems to be split it works at all but I guess we thought it was worth a shot and better than nothing in the really bad patients.

S O
S O
January 26, 2015 1:39 pm

A disadvantage of leaving this in the wound and let it be resorbed is that the wound would not have been disinfected at any time.

Observer
Observer
January 26, 2015 2:04 pm

Irony Phil is that I do a bit of coagulation analysis.

Factor VIIa catalyses the process of Factor X to Factor Xa, which then catalyses Prothrombin to Thrombin, which then converts Fibrinogen to Fibrin strands that clot the wound.

They don’t call it a “coagulation cascade” for nothing.

Now if the wound is big though, there isn’t much for the Fibrin patch to stick to, that may be why you sometimes see a “hit or miss” scenario.

I’m more worried about cutting circulation to any body part upstream of the wound. Something like the tourniquet. Stops bleeding but you can’t hold it there for too long or parts upstream will start dying.

Phil
January 26, 2015 5:01 pm

SO

That’s why its not left in. Blast injuries in particular are incredibly filthy. You’ll find dirt, filth, twigs and stones blasted right into the patients tissues.

Phil
January 26, 2015 5:04 pm

Stops bleeding but you can’t hold it there for too long or parts upstream will start dying.

You can keep it there for a good few hours, generally a lot longer than people have been led to believe. As several surgeons explained to us, they use tourniquets in routine surgical procedures all the time, often for very many hours.

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Jonathan
Jonathan
January 27, 2015 8:44 pm

@ Phil
There is not an absolute guide to tourniquet times as likelyhood of complications varies due to health, mmHg of pressure used, if you use fixed pressure or relative to the patients blood pressure. Most studies show you start to get cases of permanent nerve damage after the 2 hour mark and a number that resolve before the two hour mark. It’s been suggested that at the 3 hour point you will start to see irreversible muscle damage.

Therefore general good practice in surgery is that you ensure the time the tourniquet is inflated is recorded with a call from the scrub nurse to inform the surgeon at one hour then every 30 mins. It’s the surgeons call when he deflates, but most will not go over the two hour mark ( most literature supports this) without re perfusion of the limb for 15 minutes, you are then good to go for another hour. I’ve investigated a couple harm incidents from tourniquets so I know it does happen.

As for iv drugs that can help to control haemorrhage, tranexamic acid is a good one, look at the CRASH2 trials it shows a reduction in trauma deaths ( 1g loading dose, 1g infusion over 8 hours), best given within the golden hour. Interesting they have now started CRASH 3 which is exploring some evidence from CRASH 2 that showed tranexamic acid also reduced deaths in traumatic brain injury. ( ignore CRASH one they stopped the trail as it was a disaster, well it did prove what not to do with traumatic head injury, whoops)

The studies I have read on using recombinant activated factor VIIa in trauma are inconclusive, the only evidence of efficacy is in haemophilia patients who have developed inhibitors to factor VIII and or factor IX. So not sure why they would be using it in place of Tranexamic acid ( which is cheap and evidenced based)

As for the squirty gunk in the picture……….call me old fashioned but…….Gauze,Pressure, Gauze Gauze and more Pressure followed by more Gauze topped off with a work of art Pressure bandage ( with a big sign on it saying don’t play with it or sneak a peek) that’s how I’ve always stopped to much of the red stuff hitting the floor ( or me for that matter), oh yes and elevation.

Phil
January 27, 2015 9:27 pm

Hi Jonathan

Interesting stuff. As ever I think the balance is between writing simple protocols and allowing freedom of judgement based on evidence and experience. The protocols for CATs got more complex the higher up the med food chain you went. Toms were told to put it on as close to the wound as possible and leave it. We were taught to use a lot more judgement and see if it can be released if needed. Moot point if there’s no limb left.

The work of art pressure bandage is the problem out on the ground. Especially with body armour and kit getting in the way. I think every little helps in that situation but again, it’s about training and knowing the limitations of your kit. KISS was always something I taught.

Secundius
Secundius
May 12, 2015 3:13 pm

Sound a lot like QuikClot or BloodStop. Another Trick I learned is for Bigger Wounds, GlueTray’s for catching Mice and Rats. The Glue will form a AirTight seal around the Wound, until you can get to the Nearest Hospital. Anyone with BOB’s in their Vehicles should consider carrying a few…

Secundius
Secundius
May 13, 2015 12:07 am

FYI: VetiGel

Anyone interested in purchasing VetiGel, Forget It. I’ve tried everywhere, It’s not for SALE AT THIS TIME, according to the Maker’s of the Product. Clinic Trials are Far and Few Between. Some Veterinarians have been given Test Trial Samples, but where and whereabouts are unknown…

Aaron Boeh
Aaron Boeh
August 31, 2015 5:28 pm

When dealing with patients where exsanguination is an immediate threat. I like to go by the lessons that my paramedic instructor taught me, the worse they are, the less toys you bring. This is because of the largely immutable truth about the emergent patient; that time is life and limb. Having a tool that can be quickly and minimally invasive that is aggressive in treating these life threatening wounds is something that should be eagerly welcomed and cautiously progressed to FDA approval. But I see that these treatments will always be used in conjunction with the application of tourniquets and other basic mechanical interventions such as elevation. The reason why is quite simply due to the mechanism that the tourniquet puts into action it slows bleeding. By this action the edges of the laceration, penetration, tear, what have you, will move closer together. In laymen’s terms, if you have a garden where the nozzle suddenly becomes loosened what is the first action one would perform to fix the problem? They would manually put a kink (tourniquet) in the hose (artery/large vein) in order to reduce the pressure, thus allowing the nozzle to quickly be retightened (reducing the the edges of the wound, allowing the the gasket ( Vetigel, QuikClot..etc..) to make a more effective and efficient seal, this seal is then reinforced by packing immobilization and “DO NOT TOUCH” labeling. Once the said seal is achieved, the kink (tourniquet) can slowly be released or in a sense throttled/titrated to achieve the cessation of bleeding and the resumption of circulation to the most effective degree possible. Risk factors to the use of these agents can as well be effectively reduced when used in conjuction with the above stated, simply because less would be required to stabilize the wound. Also there most likely will have to be a significant amount of data that would show how Vetigel is broken down in the body and how it will effect the risk of embolus and production of free radicals in the body.
In my experience there is also anothe seemingly immutable clause when dealing with the critically sick and wounded, and that is fast and or drastic changes to the body weather dealing with the affliction of the injury/illness itself or the agressiveness of the treatment that is used to stabilize them causes the body to react in ataxic and often catastrophic ways. That is why oddly enough, maintaining the patients will and hope to survive alive and employ effective and efficient pain managment early on, in conjunction with agressive treatment; I believe gives the patient a much better chance. I also want to hit on a point about the practice of medicine, and that is in EMS and mainstream medicine, they only provide and adjunct or crutch in a sense, in order to support the body to heal itself, we as providers can never be as arrogant to assume that we cure and or heal, but more we give the patient a chance to make a recovery and to sign those hospital discharge papers while in a state of homeostasis.
-Aaron Boeh, NR-Paramedic.