The use of a sterilized
molecular sieve material, such as
zeolite, in a binding material to treat wounds was patented by Frank Hursey in 1989.[2] Following the
September 11 attacks, the US armed forces conducted a study comparing different antihemorrhagic technologies, in which QuikClot received the best score.[3] Another study found that when used to treat lethal groin injuries in swine, the treated animals had a 100% survival rate.[4] Following these tests, the US armed forces approved its use in Afghanistan and Iraq.[citation needed]
Zeolite
The original formulation of the product contained the active ingredient
zeolite, which promoted
blood clotting. The zeolite would have an
exothermic (heat-releasing) reaction with blood during the clotting process, which could cause
second-degree burns.[5] Because of this, the product was not available for retail and was only used in emergency scenarios, such as in combat. Newer zeolite formulas come pre-hydrated, which produce less heat, and can be used more safely to pack wounds and stop hemorrhage.[citation needed]
Kaolin
By 2009, QuikClot devices were made of gauze impregnated with
kaolin instead of using zeolite. The kaolin device performed equivalently to previously developed hemostatic bandages.[6] Kaolin doesn't trigger
skin allergies due to its inert (nonreactive) characteristics.[7]
Mechanism
QuikClot was originally available as a
granulate to be poured directly on a wound to stem bleeding.[citation needed]
The Kaolin in QuikClot Interventional bandages absorb the water molecules in blood, leaving behind the relatively bigger
platelets and
clotting factor molecules. The higher concentration of these remaining cells and molecules cause them to naturally
clot faster.[8] Kaolin activates
factor XII, a protein factor which assists in the initiation of the coagulation cascade, a protein chain reaction which promotes blood clotting as a result of trauma. Later, QuikClot was formulated using
zeolitebeads, which promoted clotting directly through
activation of the
coagulation cascade.[9]
Use by the US military
In the Tactical Combat Casualty Care Guidelines published by the
CoTCCC (Committee on Tactical Combat Casualty Care) in 2014, QuikClot Combat Gauze was listed as the ideal hemostatic dressing to be used for external hemorrhage not amenable to
tourniquet use or as an adjunct to tourniquet removal if evacuation time is anticipated to be longer than 2 hours.[10] In the TCCC Guidelines published in 2021, Combat Gauze remained the choice hemostatic dressing for such an injury.[11]
^Ronald E. Peterson (8 April 2009).
K090620 510(k) Summary(PDF) (Report).
FDA. p. 1. Retrieved 26 April 2023. The hemostatic pad is a hemostatic dressing made of soft, white, kaolin impregnated gauze, configured in a 1½" long by 1½" wide by ½" thick multi-layer pad.