Teamwork, Chance and Product Development

Even something as seemingly ordinary as a bandage can require a team of individuals to bring a product to market.

The use of a gauze pad to control bleeding dates back at least to the Roman Empire. However, in a critical injury, that gauze pad alone won't reduce bleeding quickly enough for the blood's clotting agents to perform their task. In 1995, Army Dr. (Lt. Col) John Holcomb returned from combat duty in Somalia to a military trauma research position at Fort Sam Houston. He came across an article in a medical journal by Dr. (Col.) John Hess at Walter Reed Army Medical Center, Washington, DC, which described a method of treating severe wounds with a bandage coated with dried fibrinogen and thrombin, two proteins in blood plasma that are the body's natural clotting agents. A colleague of Col. Hess's had been working at the American Red Cross' Jerome H. Holland Laboratory of Medical Science, Rockville, MD, and found researcher Dr. Martin McPhee had created such a bandage, but lacked facilities and funds to further develop it. Dr. Holcomb volunteered to assist with development of the product.

The fibrin bandage uses a backing of resorbable material. Currently being used is Vicryl, the same material used in absorbable sutures. To mass-produce the bandage, according to Dr. Hess, only human clotting proteins can be used -- there are cross-reactivity factors from other animals that the human body rejects. By coincidence, research at the Holland lab had also found that the human proteins could be grown in milk and, with a bit of gene splicing, cows in a select herd could conceivably produce fibrinogen and thrombin (in place of milk protein), with each bovine factory outputting about 10 pounds of milk per day.

Dr. Holcomb has identified many potential applications for the fibrin bandage, such as helping bone regrowth in cases of injury or cancer. He also directs lab studies, including one where the bandage stopped blood loss in a severely wounded liver in just two minutes. The bandage may be on the commercial market within the next 10 years.

-- Richard Mandel

For more information, contact Dr. Marvin Rogul, Associate Director, Walter Reed Institute of Research, Walter Reed Army Medical Center, Washington, DC 20307-5100. 202-782-7580. Circle 408.