In the Field
XStat fills a specific niche: the deep, narrow gunshot tract in the groin or axilla where you cannot get a hand in to pack effectively. The applicator looks like a large syringe filled with small white tablets. Insert the tip into the wound, push the plunger, and 92 mini-sponges expand against the bleeding source within 20 seconds. Unlike gauze, you do not remove the sponges in the field. They are tracked and counted (each sponge is radio-opaque) and removed in the OR during definitive wound exploration. Operational utility is in the wounds where every other hemostatic struggles.
Common Mistake
Removing XStat in the field. The product is designed to stay in the wound until surgical removal. Pulling it out before definitive care defeats its purpose and re-initiates hemorrhage in a wound that already failed standard packing. The other mistake is using XStat as a first-line hemostatic for wounds that hemostatic gauze can handle. The cost and supply chain make XStat an escalation, not a default.
Technical Detail
Manufactured by RevMedX. Each XStat applicator contains 92 cellulose mini-sponges coated with chitosan. Sponge dimensions approximately 1 cm diameter discs. On contact with blood, sponges expand 10 to 15 times their compressed volume within 20 seconds, generating outward pressure against vessel walls. Each sponge contains a radio-opaque marker for accurate surgical retrieval count. CoTCCC-recommended since 2015 for deep narrow-tract junctional hemorrhage. TCCC 2026 specifies XStat is not removed in the field; additional XStat, hemostatic dressings, or trauma dressings may be applied over it. Three-minute direct pressure is optional with XStat (in contrast to kaolin and chitosan gauze). Applicators come in standard (30 mL) and pediatric (12 mL) sizes.
