China
Africa
Explore chapters and articles related to this topic
Laboratory Exercise
Published in Jeffrey A Sherman, Oral Radiosurgery, 2020
Using a partially rectified waveform, a ball electrode tip (135) is placed on the beaks of a hemostat or metal tissue forceps (Figure 8.12). The power is activated and the metal instrument is lightly moved over the meat, leaving a small trail of coagulation. The ball is then placed on the handle of the hemostat or tissue forceps and the procedure performed once more. The radio signal passes from the electrode to the beaks of the hemostat, which is the point of least resistance to the tissue, with no detrimental effects to the doctor. This procedure could be used to cauterize a bleeding vessel by ligating it between the beaks of the hemostat and activating the power. This is the same principle as that used to cauterize hemorrhagic tissue while performing endodontic therapy. A reamer or file is placed in the canal approximately 0.5 mm short of the apex, the ball electrode is touched to the metal instrument and the radio signal travels to the instrument tip cauterizing any hemorrhagic tissue (Figure 8.13).
Topical Therapy: Cyanoacrylates and Other Modalities
Published in John P. Papp, Endoscopie Control of Gastrointestinal Hemorrhage, 2019
There are rather strict limitations on the size of the biopsy channel. Whenever the biopsy channel is increased or a second channel added, a compromise must be made between enlarging the total diameter of the instrument or reducing the visual and light-carrying bundles. These limitations exclude the attractive technique of controlling bleeding using conventional surgical methods, i.e., mechanically occluding the vessel with hemostat clips or sutures. Some attempts have been made to produce clips that can be inserted through the endoscope. It has not been feasible to obtain large enough clips to control bleeding and which could be passed through the channel of an endoscope. It is particularly difficult to close a clip on a bleeding vessel. To my knowledge, no one has attempted to use suture material through an endoscope; for this does not seem to be feasible with present instruments. There remains the possibility of modified clips being used through a large-channel endoscope.
Basics of nail surgery
Published in Archana Singal, Shekhar Neema, Piyush Kumar, Nail Disorders, 2019
Shilpa Kapanigowda, Biju Vasudevan
The most commonly used tourniquet is the surgical gloves. For nail surgeries of the hand, the patient is made to wear the glove. On the digit to be operated glove is cut at the tip and rolled over till the base of the digit, slowly exsanguinating the digit (Figure 29.9). This technique, apart from providing a bloodless field, also provides sterile environment in the adjacent digits. However, in toenail surgeries, instead of full gloves a part of the finger glove is cut like a tube, encircled over digit, and slowly exsanguinated till the base and then further tightened with hemostat (Figure 29.10). The use of hemostat to secure the tourniquet at the base may also interfere with the operative field or may loosen out during the procedure. The movement and manipulation of the digit during surgery are also restricted by attaching a hemostat at its base.
Brachial distal biceps injuries
Published in The Physician and Sportsmedicine, 2019
Drew Krumm, Peter Lasater, Guillaume Dumont, Travis J. Menge
Several options are available for operative repair of distal biceps avulsion injuries. They differ in the amount of incisions made as well as the method of fixation. The anterior single-incision technique uses the interval between the brachioradialis and pronator teres through an incision made in the antecubital fossa. The dual-incision technique uses one small incision in the antecubital fossa and a second incision over the posterolateral elbow. The biceps is identified through the incision in the antecubital fossa and careful dissection is performed to its insertion on the radial tuberosity. A hemostat is inserted medially within the interosseous space, piercing the anconeus and tenting the skin on the dorsal forearm, identifying the location of the second incision over the posterolateral elbow. The interval for this incision is between the extensor carpi ulnaris and extensor digitorum communis.
Potent Hemostatic Efficacy of a Novel Recombinant Fibrin Sealant Patch (KTF-374) in Rabbit Bleeding Models
Published in Journal of Investigative Surgery, 2019
Sumika Miyabashira (Tanaka), Takayuki Imamura, Miho Fujimoto, Akitoshi Ohno, Tsunefumi Kobayashi, Noriko Shinya
Hemostatic efficacy was assessed in three rabbit models of severe bleeding: partial hepatectomy, caudal vena cava resection, and ventral aortic puncture. The partial hepatectomy model replicates bleeding from solid organs, specifically oozing of blood from solid organs. The caudal vena cava resection model replicates venous bleeding, specifically accidental surgical bleeding characterized by gushing of blood. The ventral aortic puncture model replicates arterial bleeding, characterized by spurting of blood due to the direct influence of blood pressure. Our results suggest that KTF-374 may be effective against a variety of bleeding patterns, namely, oozing, gushing, and spurting. This could potentially make it an effective hemostat in a wide range of operations. In the following section, we will review the possible reasons why KTF-374 had such potent hemostatic efficacy.
Cost–consequence analysis of a hemostatic matrix alone or in combination for spine surgery patients
Published in Journal of Medical Economics, 2018
Manuel G. Ramirez, Xiaoli Niu, Josh Epstein, Dongyan Yang
The effectiveness of using a hemostatic flowable matrix only and hemostatic flowable matrix plus gelatin/thrombin flowable hemostat in combination to achieve hemostasis in spinal surgery was only recently assessed in a retrospective analysis of a large hospital database4. The study by Ramirez et al.4 adds to the literature on the combination use of flowable and non-flowable hemostat by conducting an observational retrospective database analysis with Premier’s US Hospital Database of hospitalizations and discharges that occurred between 1 October 2010 and 30 September 2015. The authors studied 15,105 propensity-matched pairs (1:1) of spine-surgery cases who underwent severe, major or minor spine surgeries. The analysis included cases where Floseal only (F) or Floseal plus gelatin/thrombin (F + G/T) was used, patients had complete demographic/baseline values and evaluable outcome measures existed. Ramirez et al.4 showed that F cases compared to F + G/T cases had significantly decreased hospital length of stay (LOS) (−0.45 days, p < .0001), surgery time (−39 minutes, p < .0001) and use of hemostat agent (−12.5 mL, p < .0001). In addition, F cases required significantly fewer interoperative, perioperative, postoperative and pure blood transfusions (p < .0001)4.