New biologicals to assist clotting

Severe hemorrhage causes significant metabolic and cellular dysfunction secondary to deficient tissue perfusion and oxygen delivery. If bleeding continues destabilization, hypoxia, multiple organ failure, and death will occur. Techniques employed to promote hemostasis include surgical suture ligatures, cautery, chemical agents, self-assembling nanoparticles, and physical methods like mechanical pressure. Improved understanding of the natural clotting cascade has allowed newly designed agents to become more targeted for clinical and military use. This chapter discusses current and developing hemostatic techniques, including topical matrix agents, biologically inspired agents, intravenous synthetic and cell-derived agents developed with nanotechnology, and external hemostatic dressings.