Developing Nonwoven Cotton Materials As Prolonged Battlefield Care Dressings

Introduction: The changing battlefield in recent years has resulted in smaller, more widely dispersed combat areas and reduced capability for transport of casualties to definitive surgical care.   Thus, delayed closure of combat wounds has become a critical issue. Overlapping with multiple functionalities that a type of dressing required to address this scenario, is the need to develop cotton-based hemorrhage control dressings with improved functionality in a similar combat arena. Among properties of durability and rapid blood clotting performance the need for antibacterial activity is required. Spun bond nonwovens of varying surface polarity were designed and prepared based on ratios of greige cotton/ bleached cotton/polypropylene fibers. Thromboelastographic analysis was performed on fabric samples in citrated blood to evaluate the rate and strength of fibrin and clot formation. Lee White clotting times were obtained to assess the materials clotting activity in platelet fresh blood.  AATCC 100 assays were performed to assess antimicrobial activity. Electrokinetic analysis of samples was performed to analyze for material surface polarity i.e. plateau potential, and fiber swell ratio. Hemostatic properties varied with composition ratios, fiber density, and process hydrostatic pressures and speeds. A correlation of increased percent greige cotton and decreased clotting time demonstrates that greige cotton may be utilized in hemostatic dressings. Conclusion: Hydroentanglement is an efficient and effective process for imparting structural integrity to cotton based textiles, while conserving enhanced hemostatic function.  The conference of bacteriostatic activity is possible with greige cotton modification by ascorbic acid.   This study demonstrates that an affordable and effective hemostatic gauze can be constructed from commonly available materials using high throughput manufacturing methods.