{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T21:47:06Z","timestamp":1768340826092,"version":"3.49.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","funder":[{"name":"Navy CIP","award":["NMCP.2016.0012"],"award-info":[{"award-number":["NMCP.2016.0012"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Exsanguinating hemorrhage is a primary cause of battlefield death. The iTClamp is a relatively new device (FDA approval in 2013) that takes a different approach to hemorrhage control by applying mechanism wound closure. However, no previous studies have explored the feasibility of utilizing the iTClamp in conjunction with hemostatic packing. To fill this important gap in the literature, a novel swine model was developed, and a total of 12 trials were performed using QuikClot Combat Gauze or XSTAT sponges in conjunction with the iTClamp to treat arterial injuries through 5 cm or 10 cm skin incisions in the groin, axilla, or neck. First-attempt application success rate, application time, and blood loss were recorded. Hemostasis was achieved on all wounds, though reapplication was required in one Combat Gauze and three XSTAT applications. Application averaged ~50% slower for Combat Gauze (M = 41 seconds, 95%CI: 22\u201332 seconds) than for XSTAT (M = 27 seconds, 95%CI: 35\u201347 seconds). XSTAT application was faster than Combat Gauze for each wound location and size. The 10 cm wounds took ~10 seconds (36%) longer to close (M = 27 seconds, 95%CI: 35\u201347 seconds) than the 5 cm wounds (M = 27 seconds, 95%CI: 35\u201347 seconds). Blood loss was similar for Combat Gauze (M = 51 mL, 95%CI: 25\u201376 mL) and XSTAT (M = 60 mL, 95%CI: 30\u201390 mL). Blood loss was roughly twice as great for 10 cm wounds (M = 73 mL, 95%CI: 47\u2013100 mL) than for 5 cm wounds (M = 38 mL, 95%CI: 18\u201357 mL). This pilot study supports the feasibility of a novel model for testing the iTClamp in conjunction with hemostatic packing towards controlling junctional hemorrhage.<\/jats:p>","DOI":"10.1093\/milmed\/usy337","type":"journal-article","created":{"date-parts":[[2019,3,22]],"date-time":"2019-03-22T16:11:12Z","timestamp":1553271072000},"page":"367-373","source":"Crossref","is-referenced-by-count":18,"title":["Pilot Study of a Novel Swine Model for Controlling Junctional Hemorrhage Using the iTClamp in Conjunction With Hemostatic Agents"],"prefix":"10.1093","volume":"184","author":[{"given":"Sean M","family":"Stuart","sequence":"first","affiliation":[{"name":"Naval Medical Center Portsmouth, 620 John Paul Jones Cir, Portsmouth, VA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Zarow","sequence":"additional","affiliation":[{"name":"Naval Medical Center Portsmouth, 620 John Paul Jones Cir, Portsmouth, VA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Walchak","sequence":"additional","affiliation":[{"name":"Naval Medical Center Portsmouth, 620 John Paul Jones Cir, Portsmouth, VA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"McLean","sequence":"additional","affiliation":[{"name":"Naval Medical Center Portsmouth, 620 John Paul Jones Cir, Portsmouth, VA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Roszko","sequence":"additional","affiliation":[{"name":"Naval Medical Center Portsmouth, 620 John Paul Jones Cir, Portsmouth, VA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,3,21]]},"reference":[{"issue":"1 Suppl","key":"2019122605080632800_usy337C1","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1097\/TA.0b013e318221147b","article-title":"Died of wounds on the battlefield: causation and implications for 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life-threatening truncal and junctional haemorrhage is the ultimate challenge in optimizing trauma care; a review of treatment options and their applicability in the civilian trauma setting","volume":"24","author":"Oostendorp","year":"2016","journal-title":"Scand J Trauma Resusc Emerg Med"},{"key":"2019122605080632800_usy337C6","first-page":"38","article-title":"New tourniquet device concepts for battlefield hemorrhage control","volume":"2","author":"Kragh","year":"2011","journal-title":"US Army Med Dep J"},{"key":"2019122605080632800_usy337C7","first-page":"1","article-title":"Comparison of three junctional tourniquets using a randomized trial design","volume":"0","author":"Gaspary","year":"2018","journal-title":"Prehosp Emerg Care"},{"issue":"1","key":"2019122605080632800_usy337C8","first-page":"49","article-title":"Assessment of users to control simulated junctional hemorrhage with the Combat Ready Clamp 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