Mastering Wound Packing: A Guide to Effective Hemorrhage Control


Wound packing is crucial in Tactical Combat Casualty Care (TCCC) and pre-hospital trauma management. As a primary intervention for controlling haemorrhage from deep wounds, wound packing is a skill that can dramatically affect patient outcomes. This guide delves into the technique, indications, and safety aspects of wound packing, along with an overview of different wound packing materials.

Section 1 – Understanding Wound Packing:

Wound packing involves applying pressure to a bleeding wound with gauze or a hemostatic agent, controlling the haemorrhage by promoting clot formation at the source of the bleeding[^1^]. It’s a procedure that can be applied in various situations, particularly in wounds located at junctional areas, where tourniquets cannot be used.

Section 2 – When to Pack a Wound:

Wound packing should be considered for deep, heavily bleeding wounds that cannot be controlled by direct pressure alone. It benefits wounds in junctional areas like the groin or axilla[^2^].

Image Suggestion: An image showing the wound packing procedure.

Section 3 – Techniques for Safe and Effective Wound Packing:

The key to effective wound packing is applying adequate pressure and ensuring the gauze or hemostatic agent is making contact with the base of the wound. This is achieved by using a finger to push the material into the wound, following the path of the wound channel. Hemostatic agents, impregnated with clot-promoting substances, can be especially effective at controlling bleeding when applied correctly[^3^].

Section 4 – Types of Wound Packing Materials:

There are two primary types of wound packing materials: standard gauze and hemostatic agents.

  • Standard gauze: Simple and cost-effective, standard gauze can be used to pack most wounds. However, it lacks the clot-promoting substances found in hemostatic agents.
  • Hemostatic agents: These materials, like kaolin or chitosan, contain substances that accelerate the clotting process. They are highly effective at controlling bleeding but are more expensive than standard gauze[^4^].

Section 5 – Battlefield Partners and Wound Packing Training:

Battlefield Partners offers specialized wound packing simulators, providing learners a realistic, hands-on experience. Our simulators facilitate practice in wound packing, fostering competency in this life-saving skill.

Section 6 – Conclusion:

Mastering wound packing is an integral part of pre-hospital and battlefield medicine. Regular training and staying up-to-date on best practices in wound packing can significantly improve patient outcomes.

Category: Procedural Guide

Tags: Wound Packing, Hemorrhage Control, Tactical Combat Casualty Care (TCCC), Battlefield Medicine, Pre-Hospital Care, Wound Packing Simulator, Lifesaving Procedure

[^1^]: Bulger EM, Snyder D, Schoelles K, et al. An evidence-based prehospital guideline for external hemorrhage control: American College of Surgeons Committee on Trauma. Prehosp Emerg Care. 2014;18(2):163-173.
[^2^]: Kragh JF Jr, Dubick MA, Aden JK, et al. U.S. military use of tourniquets and hemostatic dressings in Afghanistan and Iraq. J Spec Oper Med. 2015;15(2):76-85.
[^3^]: Bennett BL, Littlejohn LF, Kheirabadi BS, et al.

Management of external hemorrhage in tactical combat casualty care: Chitosan-based hemostatic gauze dressings–TCCC guidelines-change 13-05. J Spec Oper Med. 2014;14(3):40-57.
[^4^]: Zietlow JM, Zietlow SP, Morris DS, et al. Prehospital use of hemostatic bandages and tourniquets: translation from military experience to implementation in civilian trauma care. J Spec Oper Med. 2015;15(2):48-53.

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