• R Crunkhorn, R Burnham, and G Walton.
• Department of Plastic Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
• J Laryngol Otol. 2013 Oct 1;127(10):1031-3.

BackgroundMajor haemorrhage is a catastrophic complication occurring in 3-4 per cent of head and neck cancer patients. Massive haemorrhage also causes 50 per cent of preventable deaths in combat situations. There has been a surge of interest in the development of effective haemostatic products in the military, with chitosan being one such product.Case ReportA 48-year-old lady presented with a life-threatening head and neck bleed. She was known to have a malignant peripheral nerve sheath sarcoma originating from the left parapharyngeal space. Bleeding was successfully controlled with the application of Celox™ granules, a chitosan-based product currently used in the military.ConclusionThis paper describes the first known use of a military haemostatic agent to control a malignant head and neck bleed. Celox granules can be poured directly onto a wound to enhance haemorrhage control. The suggested mechanism of action and reports of current uses of haemostatic agents are described.

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