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XStat treats bullet wounds with tiny injectable sponges


February 11, 2014

RevMedx's XStat syringe injects hemostatic sponges into deep wounds to control hemorrhage (Photo: RevMedx)

RevMedx's XStat syringe injects hemostatic sponges into deep wounds to control hemorrhage (Photo: RevMedx)

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Uncontrolled hemorrhage (bleeding out) is responsible for 80 percent of combat deaths. About the same proportion of those who die after being evacuated to a medical treatment facility also die of hemorrhage, usually associated with deep arterial wounds that cannot be treated using tourniquets – people die because we can't plug a simple hole. Now RevMedX, a small Oregon startup, has developed an alternative approach to treat such potentially survivable injuries.

War is Hell, according to US Civil War General William Tecumseh Sherman, who certainly ought to have known. Soldiers and non-combatants are parceled out by fate into neat, military categories: KIA (Killed in Action), WIA (Wounded in Action), DOW (Died of Wounds), Ready for Duty, and the ever-popular Collateral Damage. In the unpleasantness still ongoing in Iraq and Afghanistan, about 5,000 US troops have been killed, and some 50,000 injured. The combined military and civilian losses to Iraq and Afghanistan are estimated to have been some 500,000 people killed. The immediate cause of death in most of these was bleeding out.

Emergency treatment of a gunshot or other penetrating wound on the battlefield can be a horrific experience, perhaps worse than the original injury. This is particularly true when a deep artery is torn, typically at the junctions between limbs and torso or within the torso.

The bleeding from such wounds cannot be controlled using tourniquets. Rather, a combat medic packs the wound with a special gauze coated with a material (usually chitosan) that stimulates the clotting process, then applies strong direct pressure over the wound in the hopes that a clot will seal off the artery. If the bleeding is not controlled, the medic has to remove the gauze and try again. This process is so painful that, according to John Steinbaugh, a former Special Ops medic, the patient's gun is first taken away so that he will not try to kill the medic or himself to stop the agony.

The XStat sponges in their injectable form (Photo: RevMedx)

Steinbaugh retired from the military in 2012, and joined Revmedx, a small company whose goal was to find better ways of stopping bleeding on the battlefield. Among its concepts was XStat, a plastic syringe designed to pack a wound with small (1 cm, or 0.4 in) sponges made from wood pulp and coated with chitosan, a derivative of crustacean shells that triggers clot formation and has antimicrobial properties. The sponges are also marked with an x-ray absorbing material so they can be located and removed from the wound once surgical treatment is available.

Two sizes of syringes were chosen, one 30 mm (1.18 in) in diameter for deep open wounds, and another that is 12 mm (0.5 in) in diameter to treat deep gunshot wounds. After conducting tests of early prototypes, the final development was carried under a US$5 million U.S. Army contract.

The sponges expand in the wound to fill the cavity, and apply enough pressure to stop arterial bleeding. They adhere to wet surfaces, which counters any tendency for the pressure to push the packing out of the wound. In most cases, an arterial wound treated using XStat stops bleeding within about 15 seconds. XStat is currently awaiting FDA approval, bolstered by a request from the US Army for expedited consideration.

Source: RevMedx via Popular Science

About the Author
Brian Dodson From an early age Brian wanted to become a scientist. He did, earning a Ph.D. in physics and embarking on an R&D career which has recently broken the 40th anniversary. What he didn't expect was that along the way he would become a patent agent, a rocket scientist, a gourmet cook, a biotech entrepreneur, an opera tenor and a science writer. All articles by Brian Dodson

I am a 1st aid officer (not a medic by any means), but I was told that in battle fields and rough neighbourhoods, medics and ambulance officers carry tampons for plugging bullet wounds. It makes perfect sense to me. I wonder if this is actually any better? Though I'm assuming that this can be delivered deeper in to the wound if you get my drift.

Simon Sammut

It reminds me of the tradeoff of closing serious wounds with crazy glue. You can get him to stop bleeding and even bring the patent back to marginal functionality but you are absolutely going to get massive infections.


Slowburn -- it says it has antibiotic -- add goldenseal powder! In the French and Indian War, when a gut wound was a death sentence, some Indians packed goldenseal into gut bullet wounds and greatly surprised the people who shot them when they showed up in battle again, after healing.

Mark Roest

I love the comment about "plugging a simple hole"

That's an injury caused by a weapon of deadly force in the most complex of organisms on the planet, one not yet fully understood and yet a bullet wound is just a "simple hole"

Scientists, eh? WTF . . . . .

Aloysius Bear

A design of the times..?

Jon Catling

@Simon: A tampon merely absorbs the blood/liquid in the wound area and expands as a result. These things have additives that accelerate the clotting, and antimicrobial properties.

This seems like a great idea to me. I seem to recall a science fiction book where soldiers could be injected with a foam that did essentially the same thing. I guess sci-fi continues to become sci-fact.


FDA approval? Shouldn't take more than ten years.

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