No coating and no carrier gauze — six feet of pure chitosan. Pack it, hold three minutes, and make sure it comes out within 24 hours.
At a glance
10 things to know about ChitoSAM 100
What separates spun chitosan from coated gauze, how it is labeled, and what the swine and laboratory studies found.
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01
Three inches wide, six feet long
This dressing, SAM item CT100-C-EN, is 3 in. × 6 ft (7.6 cm × 1.83 m) and Z-folded4,7 — half the length of a 3 in. × 4 yd gauze such as Combat Gauze or ChitoGauze. SAM's instructions say to match the size and number of dressings to the wound and the bleeding,3 so for a deep groin or armpit cavity, carry two. SAM also makes ChitoSAM 100 as a 3 in. × 4 ft Z-fold and a 4 × 4 in. single ply.4
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02
100% chitosan — not a coating
Most chitosan dressings are ordinary gauze coated or impregnated with chitosan. ChitoSAM 100 is a nonwoven dressing spun directly from chitosan made from crustacean and snow crab shells, with no cotton, rayon or polyester.4,5 Pressed firmly into a wound, it turns gel-like as it absorbs blood;6 SAM states it works independently of the body's normal clotting processes.4
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03
Three minutes of firm pressure
SAM's instructions call for firm pressure for 3 minutes, then a cover dressing that keeps pressure on the wound.3 The TCCC Guidelines set at least 3 minutes for any hemostatic dressing.1 Both are minimums: if it is still bleeding at 3 minutes, keep holding.
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04
Out within 24 hours
The dressing must be removed within 24 hours, and any remnants rinsed from the wound with sterile saline or water.3 Tell the receiving team a chitosan dressing is in the wound and when it went in.
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05
FDA-cleared for moderate to severe bleeding
Cleared under 510(k) K133121 on 22 May 2014 as a temporary external dressing to control moderate to severe bleeding and manage external abrasions and lacerations. Each dressing is sealed in its own foil pouch and gamma-sterilized.6
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06
In coagulopathic swine, every animal survived
In a military swine model of junctional arterial bleeding with induced coagulopathy, all seven ChitoSAM 100 animals survived, against 86% with Combat Gauze, and mean blood loss was 112 mL against 260 mL.8 Seven animals per group is a small study; the authors judged most of the agents tested comparable to Combat Gauze.
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07
Practice matters with this one
In a second military swine study, providers with fewer than five prior applications needed more ChitoSAM 100 dressings to control a junctional bleed than experienced users — 2.3 against 1.9 Re-bleeding after ChitoSAM was 33% in the junctional model and 50% in the liver model, against none with Combat Gauze; neither difference was statistically significant, and survival did not differ.9 Train with it before you carry it.
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08
Blood thinners: laboratory data
In blood from patients on anticoagulant or antiplatelet drugs, Chito SAM 100 sped the onset of clotting, as did every agent tested; kaolin-based QuikClot produced the largest improvement, followed by the chitosans.10 That is a test-tube result, not a field outcome: pack and hold the same way and watch closely for re-bleeding.
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09
Made from shellfish shell
ChitoSAM 100 contains chitosan from shellfish.3 Shellfish allergy is a reaction to shellfish protein, and SAM cites a challenge study in which volunteers with documented shellfish allergy tolerated a chitosan bandage without reaction.5,11 SAM's advice: if shellfish allergy is a concern, consult a doctor.3 In a life-threatening bleed, a reported allergy is not a reason to withhold it.
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10
Five-year shelf life — store it dry and out of the sun
SAM labels storage at 15–35 °C (59–95 °F), dry and away from sunlight,3 with a five-year shelf life.5 The pouch tears open from any edge.4 Do not use a dressing whose package is damaged or open.3
How to pack ChitoSAM 100
SAM's instructions, in the packing order taught in TCCC, TECC and public bleeding-control courses.
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1Find the source. Expose the wound and find where the blood is actually coming from. Keep direct pressure on it with your hand while you tear the pouch open from any edge.4
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2Start with a tight wad. Make the first folds into a firm ball — the "power ball" — and press it directly onto the bleeding source.3
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3Feed it in. Work the dressing in one or two folds at a time, keeping pressure on what is already packed.
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4Fill every corner. Pack tightly to the source and leave no empty space. Match the number of dressings to the wound — a deep cavity may take a second one.3
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5Hold firm pressure. At least 3 minutes, per SAM's instructions and the TCCC Guidelines1,3 — and until the bleeding has stopped.
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6Lock it in. Secure it with a cover or pressure dressing that keeps pressure on the wound.3
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7If it keeps bleeding, repack. Remove the packing and pack again with a fresh dressing, the same type or another hemostatic.1 Piling more gauze on top of a failed pack does not fix it.
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8Hand it off. Tell the receiving team a 100% chitosan dressing is in the wound and when it went in. It must come out within 24 hours, with remnants rinsed out with sterile saline or water.3
Where it fits
- Junctional wounds — groin and armpit — where a limb tourniquet cannot be applied
- Neck wounds, packed with care so the airway is not compressed; the lower neck above the collarbone can be packed
- Deep limb wounds where a tourniquet is not possible, or as an adjunct when a trained provider converts a tourniquet1
- Bleeding lacerations and abrasions6
- The chest or abdomen — never pack into the chest or abdominal cavity
- Life-threatening limb bleeding a tourniquet can control — tourniquet first1
- Over the eyes3
- Staying in place longer than 24 hours3
- Practice — train with inert trainers, not live dressings
The evidence
Every study cited above, what it tested, and how strong the evidence is.
| Study | Evidence type | What was studied | What it found |
|---|---|---|---|
| Gerling et al., J Trauma Acute Care Surg 2023 | Animal · randomized | ChitoSAM 100 vs Combat Gauze and six other agents, coagulopathic swine, junctional arterial injury, 7 per group | Survival 100% vs 86% Combat Gauze; blood loss 112 ± 115 mL vs 260 ± 319 mL; distal perfusion on angiography 43% vs 62% |
| Patterson et al., PLoS One 2025 | Animal · randomized | ChitoSAM 100 vs Combat Gauze, Celox Rapid, EVARREST and XStat, 60 hemodiluted swine, femoral and liver injuries, novice vs experienced users | Novices needed more ChitoSAM applications for the junctional bleed (2.3 vs 1, p = 0.0104); re-bleeding 33% junctional and 50% liver vs 0% Combat Gauze, not significant; survival no different |
| Lechner et al., Transfusion 2023 | Laboratory | Chito SAM 100 and six other agents in blood from patients on anticoagulant or antiplatelet drugs, rotational thromboelastometry | Every agent sped clotting onset; QuikClot most, followed by the chitosans including Chito SAM 100 |
| FDA 510(k) K133121 summary, 2014 | Animal · regulatory testing | Swine hemostasis testing against Celox predicate devices, plus bench and biocompatibility testing | Found substantially equivalent and cleared 22 May 2014; clinical testing was not required |
| Waibel et al., Mil Med 2011 | Human · safety challenge | HemCon chitosan bandage (not ChitoSAM) applied to volunteers with documented shellfish allergy; cited by SAM | All subjects tolerated the bandage without reaction |
The ChitoSAM 100 studies above are animal and laboratory studies; the human study tested a different chitosan bandage. Swine results depend on the injury model, the hold time and who applies the dressing.
How it compares
The packing options a buyer most often weighs against ChitoSAM 100.
| ChitoSAM 100 | ChitoGauze XR PRO | Celox Rapid | Combat Gauze | |
|---|---|---|---|---|
| Material | 100% chitosan, spun nonwoven | Chitosan coating on polyester/rayon gauze | Chito-R™ chitosan granules bonded to gauze | Kaolin (mineral) on nonwoven gauze |
| Strip | 3 in. × 6 ft Z-fold | 3 in. × 4 yd (12 ft) Z-fold | 3 in. × 5 ft Z-fold | 3 in. × 4 yd (12 ft) Z-fold |
| Labeled pressure hold | 3 min, firm | Until bleeding is controlled | 60 s, or until bleeding stops | At least 3 min |
| evidence-based standard | No | Yes | Yes | Yes — hemostatic dressing of choice |
| Shellfish-derived | Yes | Yes | Yes | No |
Labeled hold times come from each manufacturer's instructions; the TCCC Guidelines set at least 3 minutes of direct pressure for any hemostatic dressing.1
Build the system
The tourniquets that come first, the alternatives, the bandage that holds the packing in, and a trainer to practice on.
Questions buyers ask
Package & specifications
Specifications coming soon. Contact us for detailed product information.
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