An applicator puts granules where a finger cannot easily reach — but only onto a bleeding site you can see, and only where you can hold pressure.
At a glance
12 things to know about CELOX-A
What the applicator is for, the rules printed on its label, and what the studies found — good and bad.
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01
Six grams of CELOX granules, pre-loaded
CELOX-A is an applicator delivery system pre-packed with 6 g (0.2 oz) of CELOX granules, designed to get directly to the source of bleeding in a few seconds.3 Nothing to mix or measure: open, arm the plunger, apply.2
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02
Built for knife, shrapnel and bullet entry wounds
Medtrade designs CELOX-A for knife wounds, shrapnel wounds from blasts and bullet entry wounds.3 The label indication is temporary traumatic wound treatment to control moderate-to-severe bleeding.2
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03
Three rules on the label
The bleeding site must be visualized before the granules go in; blind application to a bleeding site should be avoided; and CELOX-A is not indicated for junctional wounds that are not amenable to pressure.2 If you cannot see the source, pack the wound with hemostatic gauze instead.
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04
A five-minute hold
The label calls for covering the wound and holding firm pressure directly on it for 5 minutes, and additional pressure until the bleeding stops if it persists.2 The TCCC Guidelines set at least 3 minutes for any hemostatic dressing.1 Hold the full 5.
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05
How the granules work
CELOX granules absorb fluid from the blood and form a robust gel-like plug, concentrating red cells and plasma into a mechanical clot that clings to the surrounding tissue.3 Medtrade describes the mechanism as independent of the clotting cascade, and the granules produce no heat.3
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06
Cold blood and heparin
Medtrade reports CELOX granules stopped major arterial bleeding by coagulating the blood within 3 minutes in controlled in-vivo trials, worked in blood down to 56 °F (13 °C), and remained effective in blood containing heparin.2 In a rat femoral artery model, CELOX granules beat compression alone under hypothermia and under warfarin.11
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07
The granules have a combat record
At a Role 2 facility in Afghanistan, 21 soldiers with gunshot wounds were treated with CELOX granules: bleeding stopped on the first application in 18 and after further applications in the other 3.9 Medtrade reports the granules were delivered with an improvised applicator.3
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08
Granules versus a plain dressing
In 48 swine with a lethal groin injury and 5 minutes of pressure, CELOX granules cut re-bleeding to 0% against 83% with a standard dressing, and survival was 100% against 50%.10
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09
CELOX-A itself: packing technique mattered as much as the agent
In 80 swine with a small penetrating groin wound where the bleeding site could not be seen, CELOX-A, Combat Gauze, ChitoFlex, WoundStat and standard gauze showed no difference in initial hemostasis, re-bleeding or survival; CELOX-A outperformed WoundStat.6 The authors concluded that proper packing and pressure may matter more than the agent in small penetrating wounds.
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10
Against XStat, CELOX-A came second
In a live-tissue swine model of penetrating groin wounds with a small skin defect, CELOX-A controlled the bleeding in 3 of 6 groins; XStat and a Foley balloon each controlled 6 of 6, and medics preferred XStat.7 In a separate penetrating groin model, CELOX-A started and held hemostasis for 60 minutes, but 5 of 6 animals still needed manual pressure and application took 169 ± 73.5 seconds.8
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11
Shellfish allergy is rarely the issue
CELOX contains chitosan from shellfish, and Medtrade reports that allergy studies show no adverse reaction to date.2 In a challenge study, ten volunteers with confirmed shellfish allergy tolerated a chitosan bandage without reaction.12
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12
Sterile, single use, four years on the shelf
Each applicator is sterilized by irradiation and is single use — do not reuse or resterilize.2 Shelf life is four years from manufacture, stored dry at ambient room temperature.3 The device is listed in the FDA's unique device identification database as CELOX A, model FG08832071,4 and carries NSN 6510-01-623-9943.5
How to use CELOX-A
Medtrade's instructions, in order, with the bleeding-control doctrine around them.
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1Find the source. Expose the wound, identify the point of bleeding and apply direct pressure. Swab away excess blood where practical. You must be able to see the bleeding site before you apply granules.2
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2Open and arm. Tear open the packet and take out the applicator. Remove the clear plastic tab from the top and insert the plunger into the barrel.2
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3Uncap. When ready to apply, remove the blue end cap.2
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4Apply to the bleeding site. Use the applicator to put the granules on the bleeding site. Push the plunger in slowly while withdrawing the applicator, filling the wound above skin level. Use additional applicators or granule packs if needed.2
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5Cover and hold firm pressure. Cover the wound and press directly on it for 5 minutes — longer than the TCCC 3-minute minimum — and keep pressing until the bleeding stops.1,2
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6Lock it in. Secure with a pressure bandage so pressure stays on the wound, and discard any unused product.2
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7If it keeps bleeding. Keep pressure on. If it still bleeds, remove what you can and apply a fresh hemostatic — another applicator or a packed hemostatic gauze.1,2
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8Hand it off. Get the casualty to a medical facility, tell the receiving team chitosan granules are in the wound, and show them the empty pack.2
Where it fits
- Knife, shrapnel and bullet entry wounds with moderate-to-severe bleeding2,3
- Wounds where you can see the bleeding site and hold pressure for 5 minutes2
- A second hemostatic on a wound that needs more agent — additional applicators may be used2
- Blind application — if you cannot see the bleeding site, pack the wound with hemostatic gauze2
- Junctional wounds that are not amenable to pressure2
- The chest or abdomen — never pack or fill the chest or abdominal cavity2
- Life-threatening limb bleeding a tourniquet can control — tourniquet first1
- The eyes — keep granules away from the eyes2
- Surgical use2
The evidence
Every study cited above, what it tested, and how strong the evidence is.
| Study | Evidence type | What was studied | What it found |
|---|---|---|---|
| Pozza & Millner, Eur J Emerg Med 2011 | Human · combat case series | CELOX granules (parent product) in 21 soldiers with gunshot wounds, Role 2 facility, Afghanistan | Hemostasis at first application in 18 of 21; the other 3 after further applications |
| Waibel et al., Mil Med 2011 | Human · safety challenge | HemCon chitosan bandage applied to 10 volunteers with confirmed shellfish allergy | All tolerated the bandage without reaction; no protein detected in the chitosan |
| Littlejohn et al., Acad Emerg Med 2011 | Animal · randomized | CELOX-A vs Combat Gauze, ChitoFlex, WoundStat and standard gauze, penetrating groin wound in 80 swine, 5-minute hold | No difference in initial hemostasis, re-bleeding or survival overall; CELOX-A better than WoundStat |
| Vrancken et al., J Trauma Acute Care Surg 2023 | Animal · comparative | CELOX-A vs XStat vs Foley balloon, penetrating groin wound with small skin defect, 18 groins, military medics | Hemorrhage control 3/6 CELOX-A vs 6/6 XStat and 6/6 Foley balloon; medics preferred XStat |
| Wang et al., J Trauma Acute Care Surg 2023 | Animal · comparative | CELOX-A vs a polyacrylate dressing vs standard gauze, penetrating groin injury, 18 swine | CELOX-A held hemostasis 60 min; manual pressure needed in 5 of 6; application 169 ± 73.5 s |
| Kozen et al., Acad Emerg Med 2008 | Animal · randomized | CELOX granules (parent product) vs HemCon, QuikClot and standard dressing, lethal groin injury in 48 swine | Re-bleeding 0% vs 83% standard dressing; survival 100% vs 50% |
| Köksal et al., Ulus Travma Acil Cerrahi Derg 2011 | Animal · rat | CELOX granules (parent product) vs compression, femoral artery bleeding under normothermia, hypothermia or warfarin | Significantly better hemostasis than compression in all three conditions |
Strongest to weakest: human series, then animal studies. Three swine studies tested CELOX-A itself and show mixed results; the human series and two animal studies tested CELOX granules, the agent the applicator carries.
How it compares
The options a buyer weighs for narrow penetrating wounds.
| CELOX-A | CELOX Rapid Ribbon | XStat | Combat Gauze | |
|---|---|---|---|---|
| Format | Pre-filled applicator, 6 g chitosan granules | 1 in. × 5 ft chitosan Z-fold ribbon | Applicator of hemostatic sponges | 3 in. × 4 yd kaolin Z-fold gauze |
| Pressure hold | 5 min labeled; TCCC at least 3 min | 60 s labeled; TCCC at least 3 min | Optional (TCCC) | TCCC at least 3 min |
| Where it fits | Knife, shrapnel and bullet entry wounds with a visible bleeding site | Narrow entry wounds — bullet, blast fragment, stab | Deep, narrow-tract junctional wounds (TCCC) | Compressible bleeding a tourniquet cannot reach (TCCC) |
| evidence-based standard | No | Yes | Yes | Yes — hemostatic dressing of choice |
XStat and Combat Gauze roles and hold times come from the TCCC Guidelines;1 CELOX times come from Medtrade's instructions. Whatever the label, keep pressure on until the bleeding has stopped.
Build the system
The packing alternatives, the bandage that holds everything in, and a trainer for narrow wound tracks.
Questions buyers ask
Package & specifications
Specifications coming soon. Contact us for detailed product information.
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30-Day Returns & Medical Safety
Returns: Unused, unopened equipment in original manufacturer packaging is eligible for return within 30 days of delivery.
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Return Facility: MED-TAC International Corp., 15757 Pines Blvd, Suite 154, Pembroke Pines, FL 33027.
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