Methods for the final stop bleeding
Cardiovascular Diseases / / August 12, 2017
angioplasty and heart
(method of operation)
final stop bleeding may be mechanical, physical, chemical and biological.
Mechanical methods of stopping bleeding performed in dressing or operating under the surgical treatment of a wound or during surgery and are as follows:
a) clamping the container terminal, followed by ligation;
b) in the case of danger, sliding ligature method used chipping of the vessel, ie, before the tying thread surgical needle is passed through the vessel wall or the surrounding tissue and then encircle around the vessel and tie..;
c) ligation of the vessel throughout.
in diffuse bleeding from a wound when it is impossible to stop the bleeding, even stitching tissue in the mass, using the method of ligation supply this area of the vessel throughout.To do this, cut a separate vessel above the wound exposed and ligated.
case of injury large main vessels continued viability of the body depends on the duration of ischemia.It is known that irreversible changes begin wi
ideal way to stop bleeding in case of damage of large vessels is a vascular suture, which restores the continuity of the vascular bed.A prerequisite vascular suturing is the presence of vascular clamps, atraumatic needles and possession surgeon vascular suture technique.
There are two types of vascular suture: the side and circular.The side seam is used in the wound edge of the vessel, carrying out a longitudinal (if the value of the vessel lumen) or cross-stitching lumen.At the regional artery defect for its replacement, you can use a patch of autologous vein or synthetic material.At full suspension or the intersection of artery allocate the ends and two atraumatic sutures, imposed in the two opposite ends of the vessel, the latter bring together, knotted joints and used as taped, the edge of the vessel obvivnym crosslinked continuous suture.With a significant defect in the vessel is reduced alloprotezom its continuity.Straight Clip can be used in the application of vascular suture and the absence of vascular needle holder.
Physical methods of stopping bleeding consist in the use of high and low temperature.Hemostatic effect of heat is reduced based on its influence on the vessel, and with significant numbers of its happening coagulation of tissue proteins and blood.To this end use mostly isotonic sodium chloride solution, warmed to 45-50 ° C. At present, widespread electrocoagulation - coagulator one electrode in the form of lead plates through a gauze moistened with isotonic sodium chloride solution, the gasket tightly fixed to the extremity of the secondelectrode is free, and when you touch the hemostat coagulate the vessel.In medical practice began to be used as a laser beam scalpel that allows the operation without blood.Low temperature heat acts similarly causing depending on the amount of tissue coagulation or spasm.For this purpose, use ice, the crystallized carbon dioxide (dry ice), liquid nitrogen.
Chemical methods are divided into external and internal hemostatic agents.As outdoor use 3-5% hydrogen peroxide solution, a solution of adrenaline 1:. 1000 and other internal means consist of two groups: causing vasoconstriction (. Ergot drugs, adrenaline, noradrenaline, phenylephrine, etc.) and increase blood clotting (menadione,calcium chloride, gelatin, aminocaproic acid, gemofobin et al.).
Biological methods to stop bleeding are based on external and internal use of blood and its components (hemostatic sponge, fibrin film fractional transfusion of small doses of blood, fibrinogen, fresh plasma).