Hemostasis and its various methods with characteristics

1. TOPIC NAME
HEMOSTASIS AND ITS METHODS
BY JUNAID WARIS

2. WHAT IS HEMOSTASIS….
It is the process of forming clots in the walls of damaged blood
vessels.
ADVERSE EFFECTS OF SURGICAL BLEEDING
1.Visual obstruction of surgical
field
2. Need for blood
transfusion
3. Hypovolemic
shock

3. HOW CAN WE OVERCOME HEMOSTASIS….
 Vascular constriction
 Platelet plug
 Blood clot
 Growth of fibrous tissue into the clot

4. CHARACTERISTICS OF AN IDEAL
HEMOSTATIC AGENT:
a. Capability to stop large vessel (arterial and venous bleeding)
within minutes of application.
b. No requirement for mixing.
c. Light weight and durable.
d. Safe to use with no risk of injury to tissue.
e. Cost effective.

5. METHODS OF HEMOSTASIS
1. Mechanical 2.Thermal 3. Chemical
1.Mechanical:
A. Direct pressure
B. gauze Pads/sponges
C. sutures/staples/ligating clips
D. Hemostatic clamp

6. A. DIRECT PRESSURE:
Simplest and fastest
Arterial bleeding better controlled than venous
B. GUAZES PADS AND SPONGES:
Application of direct pressure
Packing of body cavity
Temporary method

7. C .SUTURES/STAPLES/LIGATION CLIPS:
Sutures and ties used as ligatures to tie off blood vessels
Nonabsorbable suture are used, chances of foreign body reaction
For staples-stapling device used, faster than suture application
Ligation clips- quick easy to easy
D. HEMOSTATIC CLAMP:
Clamps for occluding vessels are used to compress blood vessels
and to grasp or hold a small amount of tissue.

8. CONTINUE….
The hemostat is the most frequently used surgical instrument
and the most commonly used method of hemostasis.
Often the pressure of clamping an instrument is sufficient to
constrict and seal a vessel with minimal trauma or adjacent
necrosis.

9. 2.THERMAL:
A. Diathermy
B. Electrocautery
C. Argon beam coagulator
D.Ultrasonic-harmonic scalpel
E. Lasers

10. A .DIATHERMY:
It is useful in stopping bleeding from small blood vessels
It is used primarily to repair a detached retina and to cauterize small
warts, polyps and other small superficial lesions.
B. ELECTROCAUTERY:
oA small battery-operated pencil with a tiny thin wire loop heated by a
steady direct electric current to red heat coagulate or destroy tissue
on contact.
oHeat is transferred to tissue from preheated wire. Electrocautery
pencils are commonly used for plastic surgery, eye procedures and
vasectomies.

11. C. ARGON BEAM COAGULATOR:
High flow argon gas conduct electric current to the target
tissue and generates thermal coagulation.
The argon beam coagulator is used to control hemorrhage
from vascular structures, surface bleeding of an organ such as
the liver and diffuse oozing and to achieve hemostasis of bone
marrow.

12. D. ULTRASONIC-HARMONIC SCALPEL:
This scalpel can be used for sharp or blunt dissection without damage
to tissue.
Vibrations from blade denature protein molecules as it cuts through
tissue, producing a coagulum that seal bleeding vessels.
It is used primarily for laparoscopic thoracoscopic procedures
Less thermal damaged to tissues
E. LASERS:
Use photons to excite chromophore molecules within target tissue and
generate kinetic energy that is released as heat, cause protein
denaturation and coagulation.

13. CONTINUE……
Laser light is used for control of bleeding or for ablation and excision of
tissues in organs that can be exposed or accessible endoscopically.
Lasers effect can be enhanced by photosynthesizing agent.
3. CHEMICAL METHOD
Epinephrine:
It causes systemic vasocontraction and gastrointestinal relaxation,
stimulates the heart and dilates BRONCHI and cerebral vessels.

14. B. VITAMIN K:
It is used to treat and prevent low levels of certain substances
(blood clotting factors) that your body naturally produces.
These substances help your blood to thicken and stop bleeding
normally (e.g: after an accidental cut or injury).
C.PROTAMINE:
It acts as a heparin antagonist. It is also a weak anticoagulant.

15. D. TANNIC ACID:
A powder made from an astringent plant, tannic acid is used
occasionally on mucous membranes of the nose and throat to
help stop capillary bleeding.
E.STYPTICS:
A styptic is an agent that checks hemorrhage by causing
vasoconstriction. Styptics have the disadvantages of being
rapidly carried away by the bloodstream.