This document discusses hemostasis in veterinary surgery. It begins by defining hemostasis and its main components. Effective hemostasis provides advantages like fewer transfusions and better surgical visualization. Factors influencing bleeding and ideal characteristics of hemostatic agents are outlined. Common hemostatic techniques are categorized as mechanical, thermal, or chemical. Specific considerations for different surgical procedures are also covered. The document concludes by emphasizing the importance of proper hemostasis for surgical outcomes and patient safety.

1. Prepared by:
① Abrahim Mohammed__________
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② Badada Halake________________
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③ Diba Wario ____________________
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④ Kalid Juhar ____________________
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⑤ Kalicha Jarso __________________
4735/13
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4764/13
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DVM 4th
Year
2023
ID №
College Of Veterinary Medicine
Vet. General surgery and Anaesthesiology ( Vetm 4121)
Submitted to : Ass. Prof. Dr. Chala M.

2. Vet. General Surgery and
Anaesthesiology
HEMOSTASIS

3. Hemostasis
 Introduction
 Advantages of Effective Hemostasis During Surgery
 Factors influencing surgical bleeding
 Characteristics of an ldeal hemostatic agents for clinical use:
 Hemostasic techniques
 Specific consideration
 Hemostasis in Trauma and Emergency Surgery
 Hemostatic Challenges in Emergency Cases
 Hemostasis Assessment Techniques
 Postoperative Care and Monitoring
Conclusion
References

4. Introduction
Hemostasis
 Definition:
 Derived New Latin 'haimo'- Blood & 'stásis' - Stasis
 Process to prevent & stop bleeding
1. Vascular endothelium
2. Platelets
3. Coagulation system
4. Fibrinolysis
 Main Components of Hemostasis

5.  Fewer transfusions
 Better visualization of surgical field
 Reduced surgical time
 Decreased morbidity and motality
Advantages of Effective Hemostasis During Surgery

6. Factors influencing surgical bleeding
 Type of procedure
 Patient position
 Surgical incisions
 Exposed bone
 Large surfaces of exposed
Capillaries
 Unseen sources of bleeding
 Tissues that cannot be sutured
or
 Low-pressure suture lines
 Adheions stripped during
suryery
Procedural factors
 Speciflc anatomical considerations
 Medications (eg Anticoagulants)
 Coagulopathies
 • Platelet dysfunction or deficiency
 • Fibrinolytic activity
 Coagulaton factor deficiencies
 Medical conditions
 Nutritional status

Patient factors

7.  capability to stop large vessel arterial and venous bleeding within minutes of application when
applied to an actively bleeding wound through a pool of blood;
 no requirement for mixing or pre-application preparation;
 simplicity of application
 Light weight and durable;
 long shelf life in extreme environments;
 safe to use with no risk of injury to tissues or transmission of infection;
 cost-effective
Characteristics of an ldeal hemostatic agents for clinical use:

8. Hemostasis Techniques
① Mechanical
② Thermal
③ Chemical
 The techniques for local hemostasis may be classified as :

9.  Direct pressure
 Sutures
 Staples
 Ligating clips
 Fabric pads
 Gauzes
 Sponges
 Blood component/replacement therapy
Techniques for Maintaining Hemostasis in Surgery'
 Mechanical techniques
 Cautery
 Electrocautery
 Hemostatic scalpel
 Laser
 Cryosurgery
 Argon -beam coagulator
 Thermal techniques
 Hypotensive anesthesia
 Epinephrine
 Vitamin K
 Protamine
 Desmopressin
 Aminocaproic acid
 Tranexamic acid

 Chemical techniques

 Fibrin sealants
 Synthetic glues
 Collagen
 Cellulose
 Gelatins
 Thronbins

 Pharmacotherapy
 Topical hemostats
 Topical sealants and adhesives

10.  Mechanical Hemostasis Techniques
 Involves physically stopping bleeding by applying pressure or using ligatures, sutures, clips, or
staples.
 simplest and most commonly used technique
 Applying direct pressure to the bleeding site.
 Helps to compress the blood vessels and promote clot formation.
 A sterile gauze or cloth is typically used to apply pressure, and it is
important to maintain continuous pressure until bleeding stops..
1. Direct pressure and compression methods:

11.  Involves using a needle and thread to close or repair wounds and secure blood
vessels.
 commonly used in surgical procedures to control bleeding.
2. Ligature and suturing techniques:
 Ligature
 Involve tying off blood vessels to stop bleeding.
 can be done using absorbable or non-absorbable sutures or
specialized devices such as hemoclips or vascular staples.
 Suturing
 Mechanical Hemostasis Techniques

12. 3. Hemostatic Clips and Staples
 Hemostatic clips and staples are used to occlude blood vessels during surgery.
 They provide a quick and efficient way to achieve hemostasis without the need for
sutures.
 A tourniquet is a device used to constrict blood flow to a limb.
 It is a mechanical method as it physically compresses the blood vessels,
preventing blood flow to the area beyond the tourniquet.
4. Tourniquet
 Mechanical Hemostasis Techniques

13.  Involves using heat energy to coagulate blood vessels and achieve hemostasis.
 commonly used in various surgical procedures.
 Thermal Hemostasis Techniques
 Utilizes an electric current to generate heat for coagulation.
 Involves using a heated probe or electric current to cauterize blood vessels and seal them
off.
 effective in controlling bleeding from small vessels.
1. Cautery and Electrocautery
 Cautery
 involves using a heated instrument (cautery pen) to burn tissue and seal blood vessels.
 Electrocautery

14.  is another thermal technique used for achieving hemostasis.
 Is focused on the bleeding site, causing coagulation of blood vessels without direct contact.
2. Laser Therapy
 Thermal Hemostasis Techniques

15.  involve the use of substances or agents that promote blood clotting to stop bleeding.
 These agents can be applied topically to the bleeding site or administered systemically (orally
or intravenously) to promote clot formation.
 They work by either activating the clotting cascade or enhancing the formation of fibrin, a
protein involved in clot formation.
Chemical Hemostasis Techniques

16. Chemical Hemostasis Techniques
 are substances applied directly to a bleeding site to promote clotting and stop bleeding.
 Examples: Gelatin sponges, oxidized cellulose, fibrin sealants.
 Benefits: Rapid action, easy application, minimal systemic effects.
 Considerations: Allergies, potential for infection.
1. Topical Hemostatics and Hemostatic Agents

17. Gelatin sponges oxidized cellulose fibrin sealants

18. Chemical Hemostasis Techniques
 Hemostatic powders and granules are used to control bleeding by promoting clot formation and accelerating
the coagulation process.
 Examples: Absorbable hemostatic powders, microfibrillar collagen, zeolite-based agents.
 Benefits: Effective in controlling severe bleeding, easy to apply, can be used in various surgical procedures.
 Considerations: Potential for tissue damage, risk of infection.
2. Hemostatic Powders and Granules

19. : Absorbable hemostatic
powders,
microfibrillar collagen,  zeolite-based agents.

20.  The hemostatic management may vary depending on the surgical procedure being
performed.
 For example, in orthopedic surgeries, bone wax or a bone-sealing agent may be used
to promote hemostasis in bone tissue.
 In soft tissue surgeries, ligatures, clips, or cautery may be used to control bleeding
from blood vessels.
Specific Considerations for Different Surgical Procedures:

21. Hemostasis Considerations in Specific Surgical Procedures
Spay and Neuter Procedures
Importance of hemostasis Techniques Considerations
 Prevent excessive bleeding during
and after surgery.
 Ligating blood vessels, using
hemostatic clips or sutures.
 Avoid excessive tissue trauma,
prevent post-operative hemorrhage.

22. Importance of hemostasis Techniques Considerations
 Minimize blood loss during
complex procedures.
 Use of bone wax,
electrocautery, and topical
hemostatics.
 Protect surrounding tissues,
prevent infection.
Orthopedic Surgeries

23. Importance of hemostasis Techniques Considerations
Soft Tissue Surgeries
 Control bleeding in delicate tissues.
 Use of sutures, ligatures,
and topical hemostatics.
 Preserve tissue integrity,
minimize scarring.

24. Importance of hemostasis Techniques Considerations
Abdominal Surgeries
 Prevent intra-abdominal bleeding.
 Ligation of blood vessels,
use of hemostatic agents.
 Avoid damage to surrounding
organs, prevent post-operative
complications.

25. Techniques
Importance of hemostasis Considerations
Cardiac and Vascular Surgeries
 Ensure blood clotting during and
after procedures.
 Use of sutures, clips,
and topical
hemostatics.
 Maintain blood flow,
prevent thrombosis.

26. Techniques
Challenges Collaboration
Hemostasis in Trauma and Emergency Surgery
 High-risk bleeding
situations, limited time for
intervention.
 Multidisciplinary approach
involving surgeons,
anesthesiologists, and
emergency medicine specialists.
 Rapid control of bleeding
using direct pressure,
tourniquets, and hemostatic
agents.

27. Coagulopathy Massive Hemorrhage Damage control surgery
Hemostatic Challenges in Emergency Cases
 Abnormal clotting function
due to trauma or underlying
medical conditions.
 Rapid and significant
blood loss requiring
immediate intervention.
 Temporary measures to
control bleeding before
definitive surgical repair.

28. Physical examination Vital signs monitoring Laboratory tests
Hemostasis Assessment Techniques
 Visual inspection for signs of
bleeding, bruising, or swelling.
 Frequent measurement of
blood pressure, heart rate, and
oxygen saturation.
 Hemoglobin and hematocrit
levels to assess blood loss
and clotting function.

29. Wound assessment Vital signs monitoring Laboratory tests
 Regular inspection for signs of
bleeding, infection, or poor
healing.
 Continual monitoring of
blood pressure, heart
rate, and oxygen
saturation.
 Regular assessment of
hemoglobin and hematocrit
levels to detect any ongoing
bleeding or coagulation
abnormalities.
Postoperative Care and Monitoring

30.  Hemostasis in veterinary surgery is a critical aspect of ensuring successful
surgical outcomes and patient safety.
 It involves the control of bleeding during surgical procedures.
 Various techniques and tools are used to achieve hemostasis, including
ligatures, electrocautery, hemostatic agents, and sutures.
 The choice of method depends on the nature and severity of the bleeding, as
well as the surgeon's preference and experience.
Conclusion

31.  Proper hemostasis not only prevents excessive blood loss but also promotes
optimal wound healing and reduces the risk of postoperative complications.
 Veterinary surgeons must have a thorough understanding of the principles and
techniques of hemostasis to effectively manage bleeding during surgical
procedures.
 By implementing appropriate hemostatic measures, veterinarians can enhance
patient safety and improve surgical outcomes in their practice.
Conclusion

32. References
 Bacek LM, Monnet E. Hemostasis and coagulation disorders. In: Tobias KM,
Johnston SA, editors. Veterinary Surgery: Small Animal. 2nd ed. St. Louis, MO:
Elsevier Saunders; 2017. p. 495-511.
 Boswood A, Brodbelt D, Oyama MA, et al. Management of acute severe hemorrhage
in dogs and cats. J Vet Emerg Crit Care (San Antonio). 2010;20(1):3-23.
 Ko JC, Henry CJ, Pascoe PJ. Principles of hemostasis. In: Fossum TW, editor. Small
Animal Surgery. 5th ed. St. Louis, MO: Elsevier Mosby; 2018. p. 18-29.
 McAnulty JF, Rozanski EA, Rush JE. Hemostatic disorders. In: Silverstein DC,
Hopper K, editors. Small Animal Critical Care Medicine. 2nd ed. St. Louis, MO:
Elsevier Saunders; 2014. p. 289-298.


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