Improved Postoperative Bleeding Control Using the Fanning Pressure Dressing Technique

2021 ◽  
Author(s):  
Cecilia Ardila ◽  
Isadore S. Tarantino ◽  
Leonard H. Goldberg ◽  
Kourosh Beroukhim ◽  
Arash Kimyai-Asadi
Keyword(s):  
Postoperative Bleeding ◽  
Bleeding Control ◽  
Pressure Dressing

Autotransfusion: 15 Years Experience at Rizzoli Orthopaedic Institute

1993 ◽  
Vol 16 (5_suppl) ◽  
pp. 241-246 ◽  
Author(s):  
B. Borghi ◽  
A. Bassi ◽  
N. De Simone ◽  
A.M. Laguardia ◽  
G. Formaro
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Postoperative Bleeding ◽  
Knee Surgery ◽  
Bleeding Control ◽  
Years Of Experience ◽  
Rizzoli Orthopaedic Institute ◽  
Hip And Knee Surgery

The program of blood saving, result of 15 years of experience, includes predeposit (1977) hemodilution (1979) intra (1984) and postoperative (1985) salvage, careful intra and postoperative bleeding control, use of homologous transfusion only in case of intolerated anaemia even for 7-8g/dl Hb values. The use of autologous compared to homologous transfusion passed from 19% in 1984 to 62% in 1992. In 1992 in the surgical division of the 1st Anaesthesia and Intensive Care unit, 414 patients underwent prosthetic hip and knee surgery, 8% of these patients were homologously transfused.

scholarly journals The Analysis of Risk Factors Associated with Transcatheter Arterial Embolization for Percutaneous Nephrolithotomy

2019 ◽  
Author(s):  
Hongfei Miao ◽  
Yong Chen ◽  
Peng Ye ◽  
Qingle Zeng ◽  
Huajin Pang
Keyword(s):  
Risk Factors ◽  
Percutaneous Nephrolithotomy ◽  
Transcatheter Arterial Embolization ◽  
Clinical Success ◽  
Univariate Analysis ◽  
Postoperative Bleeding ◽  
Arterial Embolization ◽  
Gelatin Sponge ◽  
Bleeding Control ◽  
Embolic Material

Abstract Abstract Background: This study aimed to evaluate the risk factors of transcatheter arterial embolization (TAE) in managing haemorrhage associated with percutaneous nephrolithotomy (PCNL) to improve the surgical effect. Methods: From May 2007 to June 2018, 112 patients (31–60 years) who underwent TAE treatment for haemorrhage after PCNL were retrospectively analyzed. All patient data and embolization details were retrieved from medical records. Univariate analysis was used to identify the risk factors related to clinical outcomes. Results: Technical and clinical success rates were 100% and 93%, respectively. On angiography, we observed injury to the main artery in 1 patient, to secondary branch in 22, to tertiary branch in 58, and to both secondary and tertiary branches in 31. Embolic agents were coils (n =31), gelatin sponge (n=15), and gelatin sponge with coils/microcoils (n =66). Bleeding control failed in 8 patients. Eight patients opted for a second operation, 6 by repeat TAE and 2 by surgery. Bleeding was eventually controlled in all patients. Univariate analysis indicated that extent of transfusion, embolic material used, and injured branches were significantly associated with clinical failure. Conclusions: TAE is effective and safe in treating postoperative bleeding after PCNL. Massive transfusion, embolic material used, and injured branches were related to failure of bleeding control.

Management of postoperative bleeding in surgically debrided wounds: topical haemostat versus electrocautery

2020 ◽  
Vol 29 (8) ◽  
pp. 444-451
Author(s):  
Kerry T Thibodeaux ◽  
Marcus S Speyrer ◽  
Ryan P Thibodeaux ◽  
Alan A Rogers ◽  
Mark G Rippon
Keyword(s):  
Postoperative Bleeding ◽  
Bleeding Control ◽  
Effective Management ◽  
Prospective Evaluation ◽  
Surgical Wound ◽  
Time Saving ◽  
Significant Saving ◽  
Wound Debridement ◽  
The Mean ◽  
Time Savings

Objective: To compare the effectiveness of a temporary topical external haemostat (OMNI-STAT Granules, Omni-stat Medical Inc., US) versus the use of electrocautery for bleeding control in patients who have undergone surgical wound debridement. Time saved in the operating room (OR) was evaluated. Method: A prospective evaluation of use of a topical haemostat in an OR setting was compared with retrospective data collected using electrocautery to understand the time-saving benefits of using a topical haemostat versus electrocautery. Results: A total of 52 patients were treated with the topical haemostat, and 89 patients with electrocautery. The topical haemostat was shown to be as effective in achieving haemostasis post-surgical debridement as electrocautery, with the added benefits of significant time savings in the OR (reducing the mean total OR time by 19.1%). Additionally, preprocedure and surgical procedure times in patients treated with the topical haemostat were significantly reduced. The results showed that wounds treated with the topical haemostat demonstrated a more advanced stage of healing, which may be a result of the lack of tissue damage demonstrated with the topical haemostat compared with electrocautery. Conclusion: This study found that the temporary topical haemostat was equally as effective as cauterisation in achieving haemostasis. In addition, significant saving in OR time was demonstrated relative to electrocautery. The improved OR times may translate into increased cost-effectiveness, relative to electrocautery, by increasing the number of surgical cases per day and/or using resources more effectively to treat more patients. It may also enable bleeding control in the outpatient clinic or at the bedside, freeing up costly OR time and enabling more effective management of healthcare resources.

Effects on Coagulation and Fibrinolysis of Desmopressin in Patients Undergoing Total Hip Replacement

1991 ◽  
Vol 66 (06) ◽  
pp. 652-656 ◽  
Author(s):  
Per Anders Flordal ◽  
Karl-Gösta Ljungström ◽  
Jan Svensson ◽  
Brenda Ekman ◽  
Gustaf Neander
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Bleeding Time ◽  
Antithrombin Iii ◽  
Postoperative Bleeding ◽  
Double Blind ◽  
Total Hip ◽  
Von Willebrand ◽  
Willebrand Factor ◽  
Coagulation And Fibrinolysis

SummaryTwelve patients undergoing total hip replacement, with regional anaesthesia and with dextran infusion for plasma expansion and thromboprophylaxis, were given the vasopressin analogue desmopressin (DDAVP) or placebo in a randomized, double-blind prospective study. In controls (n = 6) we found a prolongation of the bleeding time, low factor VIII (FVIII) and von Willebrand factor (vWF) and a decrease in antithrombin III to levels known to be at risk for venous thrombosis. Desmopressin shortened postoperative bleeding time, gave an early FVIII/vWF complex increase, prevented antithrombin III from falling to critically low values and appeared to activate the fibrinolytic system, both by tPA increase and PAI-1 decrease.Thus in the controls we found changes in both coagulation and fibrinolysis indicating a haemorrhagic diathesis as well as a risk for thromboembolism. Desmopressin induced factor changes that possibly reduce both risks.

Major Surgery in a Subject with Factor V Deficiency

1971 ◽  
Vol 25 (03) ◽  
pp. 438-446 ◽  
Author(s):  
E. J Melliger ◽  
F Duckert
Keyword(s):  
Intercellular Space ◽  
Correct Diagnosis ◽  
Postoperative Bleeding ◽  
Major Surgery ◽  
Factor V ◽  
Factor V Deficiency ◽  
Disappearance Time ◽  
Fresh Plasma ◽  
One Year

SummaryA further case of parahaemophilia is reported. One year after the correct diagnosis had been made the patient had to undergo cholecystectomy which was performed under prophylactic substitutive treatment with fresh plasma at a factor V level of 31 %. A minimal factor V level of 11 to 12% was maintained throughout the first week after operation. There was no abnormal postoperative bleeding. The half disappearance time of factor V was found to be about 12 h. Infusion of equivalent amounts of fresh plasma supplied a higher yield of factor V in the patient’s plasma before operation than postoperatively what may be explained by an increased diffusion of factor V into the intercellular space resulting from a postoperatively increased capillar permeability. The results are compared with those of other authors.

A Simple Method of Creating LVAD Outflow Tract Aortic Anastomosis

2005 ◽  
Vol 6 (1) ◽  
pp. 53 ◽  
Author(s):  
Eugene L. Kukuy ◽  
Daniel J. Goldstein ◽  
Vivek Rao ◽  
Niloo M. Edwards ◽  
Yoshifumi Naka
Keyword(s):  
Postoperative Bleeding ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
Outflow Tract ◽  
Assist Device ◽  
Simple Method ◽  
Ventricular Assist ◽  
Anastomosis Site ◽  
Left Ventricular Assist ◽  
Aortic Anastomosis

Left ventricular assist device (LVAD) implantation is frequently complicated by intraoperative and postoperative bleeding, particularly at the aortic anastomosis site. Many modifications of the anastomosis have been attempted. We describe a simple method to anastomose the LVAD outflow tract to the ascending aorta with minimal bleeding and a short anastomosis time.

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