Developing an Ideal First Use Agent to Prevent Sepsis in Trauma Wounds During Care Under Fire

Sepsis is the greatest danger after hemorrhage in both civilian and combat-related injuries with mortality rates ranging between 19.5 - 23%. Early intervention with appropriate antibiotics, hemodynamic optimization, and supportive care are particularly vital in preventing trauma related sepsis. Treatments to prevent trauma sepsis may be confounded by the uncontrolled bleeding which often attends severe traumatic injuries and is responsible for 40% of trauma deaths, the majority of which occur in the prehospital period. Both sepsis and hemorrhage can trigger deadly inflammatory responses causing fatal injury to tissues and organs. Rapid interventions which control bleeding while reducing contamination to diminish the high mortality and morbidity rates associated with sepsis in traumatic injuries are a critical need. Remote austere environments at point of injury often delay delivering essential medical care. In military trauma wounds, this may be further exacerbated by the hostile environment.  Our proposed solution is an early application of a multi-functional wound dressing which allows dynamic release of active agents to prevent hemorrhage and sepsis with extended wear time to improve current standard of care during care under fire and prolonged field care. We hypothesize that a sustained release of antimicrobials will provide protection in the deep tissue planes of the wound and skin surface for at least 72 hours under care-under fire conditions when delivered using this wound dressing. The proposed solution will be light, easy to use, transportable and shelf-stable.