• Suzanne M Vrancken, Borger van der BurgBoudewijn L SBLSDepartment of Surgery, Alrijne Hospital, Leiderdorp, the Netherlands., Pieter W Stark, van WaesOscar J FOJFTrauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Defense Healthcare Organization, Ministry of Defense, Utrecht, the Netherlands., Joseph J DuBose, Elizabeth R Benjamin, André Lieber, VerhofstadMichael H JMHJTrauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands., Gert-Jan Kleinrensink, and Rigo Hoencamp.
• Department of Surgery, Alrijne Hospital, Leiderdorp, the Netherlands; Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. Electronic address: smvrancken@alrijne.nl.
• Injury. 2023 Jan 1; 54 (1): 214222214-222.

IntroductionPrompt and effective hemorrhage control is paramount to improve survival in patients with catastrophic bleeding. In the ever-expanding field of bleeding control techniques, there is a need for a realistic training model to practice these life-saving skills. This study aimed to create a realistic perfused post-mortem human specimen (PMHS) flow model that is suitable for training various bleeding control techniques.Materials And MethodsThis laboratory study was conducted in the SkillsLab & Simulation Center of Erasmus MC, University Medical Center Rotterdam, the Netherlands. One fresh frozen and five AnubiFiX® embalmed PMHS were used for the development of the model. Subsequent improvements in the exact preparation and design of the flow model were made based on model performance and challenges that occurred during this study and are described.ResultsCirculating arteriovenous flow with hypertonic saline was established throughout the entire body via inflow and outflow cannulas in the carotid artery and jugular vein of embalmed PMHS. We observed full circulation and major hemorrhage could be mimicked. Effective bleeding control was achieved by placing a resuscitative endovascular balloon occlusion of the aorta (REBOA) catheter in the model. Regional perfusion significantly reduced the development of tissue edema.ConclusionOur perfused PMHS model with circulating arterial and venous flow appears to be a feasible method for the training of multiple bleeding control techniques. Regional arteriovenous flow successfully reduces tissue edema and increases the durability of the model. Further research should focus on reducing edema and enhancing the durability of the model.Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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