RevMedx, an Oregon-based startup, has designed the XSTAT 30. This device is a syringe that is filled with tiny blood-absorbing sponges that is injected into a wound, sealing it in less than a minute. It was approved for civilian use by the FDA on December 7th.
When medics respond to gunshot victims, the goal is to keep the patient alive until they can be properly transported to a treatment center. The way they do that is by treating the bullet wound with gauze and applying pressure. A medic must pack gauze directly into the wound cavity, sometimes deep in the body, and keep pressure on the wound.
“According to the United States Army Institute of Surgical Research, 30 to 40 percent of civilian deaths by traumatic injury are the result of hemorrhaging,” the FDA said. “Of those deaths, 33 to 56 percent occur before the patient reaches a hospital.”
That’s why controlling severe bleeding earlier is critical step in preventing shock and even saving a life. In an effort to make the process faster and more efficient, RevMedx developed XSTAT 30, which was granted use for the battlefield in April 2014. Unlike household sponges, the ones in XSTAT 30 have to be sterile and biocompatible. The tiny sponges are made from wood pulp and coated in chitosan, an antimicrobial substance that clots the blood and comes from shrimp shells.
John Steinbaugh, retired VP and Director of Strategic Development of RevMedx, told PBS NewsHour in a segment shown below that the sponges expand up to 15 times their size when they make contact with blood. Once they expand, the sponges apply internal pressure to the walls of the wound cavity and create a barrier to block the blood flow.
While the number of sponges needed to effectively control hemorrhaging varies depending on the wound, each applicator can absorb about a pint of blood, the company says, and up to three applicators can be used on a patient. The sponges in XSTAT 30 can be used for up to four hours, according to the FDA, which gives the patient time to receive surgical care.
Despite the device’s successes, whether it’ll be significantly useful is questionable. The device is best for wounds in areas where a tourniquet can’t be placed, such as the groin or armpit. The downside, however, is that the device isn’t intended for many areas of the body: the chest, abdomen, pelvis or tissue above the collarbone.
“The key with this product, though, is it has to be placed in a fixed-sized wound,” Martin Schrieber, chief of trauma at the Oregon Health and Science University and has led trauma care in the military, told PBS NewsHour. “If you have a penetrating injury to, say, the area under the clavicle, which creates a very fixed wound, this could be very effective.”
There are other issues: Putting aside the long list of body parts where an XSTAT can’t be used, the sponges also aren’t biodegradable, which means they have to be pulled out after treatment. Luckily each sponge is marked with X’s that show up in x-rays, in case one is accidentally left in the wound after surgery.