Surgical hemostasis

Journal of Neurosurgery
C A Owen, E J Bowie

Abstract

Every surgical procedure taxes the hemostatic defenses of the patient. If his hemostatic mechanism is sound, he is unlikely to have a bleeding problem during or after an operation, unless, of course, a suture or clip slips off. Two classes of patients do present bleeding problems to the surgeon. One group has a pre-existing bleeding tendency, the other acquires it during or after the operation. The recognition of patients with severe hemostatic disabilities, such as hemophilia, presents no problem since the patient is aware of the disease. The mild bleeder is less likely to be detected by screening tests than by adroit questioning. The major hemostatic defect that may develop during an operation, or shortly thereafter, is disseminated intravascular coagulation. This syndrome, always secondary, may accompany shock, mismatched blood transfusion, septicemia, or extensive malignancy. Its prevention or early recongnition is much easier than treatment after circulating platelets and some coagulation factors have been consumed and fibrinolysis is destroying fibrin and fibrinogen.

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Citations

May 1, 1987·Journal of Neurology, Neurosurgery, and Psychiatry·J J Van der Sande, H R Buller
Jan 1, 1981·Journal of Neurosurgery·S Wessler, S N Gitel
May 1, 1983·Journal of Neurosurgery·J J van der SandeM L Bouwhuis-Hoogerwerf
Apr 6, 2016·Anesthesiology and Pain Medicine·Zahid Hussain KhanCyrus Emir Alavi
Jan 2, 2008·Acta neurochirurgica·B S HarhangiA I R Maas
Aug 1, 1981·Biological Reviews of the Cambridge Philosophical Society·M H Johnson
Dec 4, 1984·Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences·T J MohunJ B Gurdon

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