XSTAT - Injectable Hemostatic Microsponge Device
The product you're describing is XSTAT, an FDA-cleared hemostatic device that consists of small cellulose-based minisponges contained in a syringe applicator that are injected directly into a wound cavity to achieve rapid hemorrhage control. 1, 2
Product Description and Mechanism
XSTAT contains rapidly expanding cellulose minisponges that are deployed via syringe applicator directly into wound cavities, where they expand upon contact with blood to fill the wound space and create tamponade effect 1, 2
The microsponges work through dual mechanisms: high water absorption capacity that concentrates blood cells and enhances coagulation, combined with rapid expansion that applies direct pressure to bleeding vessels 1, 3
Each sponge expands significantly after absorbing blood, creating a shape-fixed mass with sufficient mechanical strength to maintain pressure on the wound 3
The device was specifically developed for severe, life-threatening bleeding from junctional wounds not amenable to tourniquet application, particularly in penetrating trauma 2
Clinical Efficacy Data
In a lethal noncompressible hemorrhage model (subclavian artery/vein transection), XSTAT achieved 100% survival at 60 minutes versus 37.5% with Combat Gauze (p = 0.026), with dramatically reduced blood loss (118 mL vs 1,242 mL, p = 0.021) 1
Application time was only 25 seconds compared to 420 seconds for conventional dressings (p = 0.004), and no external pressure was required unlike traditional hemostatic agents 1
In civilian trauma center experience with 10 deployments, XSTAT stopped bleeding on first deployment in 90% of cases, with the remaining case requiring only one repeat injection 2
The device demonstrated efficacy across a range of injuries including arterial injuries in 80% of cases, with dwell times ranging from 1 to 40 hours (median 15 hours) 2
Critical Safety Considerations and Pitfalls
Radiographic clearance is mandatory after sponge removal - retained sponges were identified in 2 of 10 patients on initial post-removal x-rays, emphasizing the need for systematic verification 2
The microsponges are radiopaque to facilitate identification and complete removal during definitive surgical management 2
No embolic complications or technical device failures were reported in clinical use, and no deaths occurred in the initial civilian trauma series 2
The device should be reserved for cavitary wounds with active hemorrhage where traditional compression or tourniquets cannot be applied effectively 2
Comparison to Other Hemostatic Agents
While polysaccharide-based hemostatics exist in various forms (pads, patches, bandages), XSTAT is unique as an injectable syringe-based delivery system specifically designed for deep, non-compressible wounds 4
Traditional hemostatic agents like gelatin-based products require external pressure and longer application times, whereas XSTAT requires no external compression and achieves hemostasis in under 30 seconds 1