Development of haemostatic decontaminants for treatment of wounds contaminated with chemical warfare agents. 3: Evaluation of in vitro topical decontamination efficacy using damaged skin

Abstract

This document is the Accepted Manuscript version of the following article: Lydon, H. L., Hall, C. A., Dalton, C. H., Chipman, J. K., Graham, J. S., and Chilcott, R. P., ‘Development of haemostatic decontaminants for treatment of wounds contaminated with chemical warfare agends. 3: Evaluation of in vitro topical decontamination efficacy using damaged skin’, Journal of Applied Toxicology, Vol. 37 (8): 976-984, February 2017. The Version of Record is available online at doi: doi: 10.1002/jat.3446. Copyright © 2017 John Wiley & Sons, Ltd.Previous studies have demonstrated that haemostatic products with an absorptive mechanism of action retain their clotting efficiency in the presence of toxic materials and are effective in decontaminating chemical warfare (CW) agents when applied to normal, intact skin. The purpose of this in vitro study was to assess three candidate haemostatic products for effectiveness in the decontamination of superficially damaged porcine skin exposed to the radiolabelled CW agents soman (GD), VX and sulphur mustard (HD). Controlled physical damage (removal of the upper 100 µm skin layer) resulted in significant enhancement of the dermal absorption of all three CW agents. Of the haemostatic products assessed, WoundStat™ was consistently the most effective, being equivalent in performance to a standard military decontaminant (fuller’s earth). These data suggest that judicious application of haemostatic products to wounds contaminated with CW agents may be a viable option for the clinical management of casualties presenting with contaminated, haemorrhaging injuries. Further studies using a relevant animal model are required to confirm the potential clinical efficacy of WoundStat™ for treating wounds contaminated with CW agents.Peer reviewe