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Samsul Maarif
Excess perioperative bleeding remains a major
complication following surgery, resulting in
increased morbidity and mortality
There are two main causes of perioperative
bleeding.
Vasoconstriction
Platelet plug formation, after vasoconstriction, platelets are
activated by thrombin and aggregate at the site of injury to form
a temporary platelet plug.
Fibrin clot formation, To stabilize the initially platelet plug
Coagulation Cascade
Management in perioperative bleeding :
Mechanical methods
Direct pressure
Sutures/ ligating clips
Thermal/energy-based methods
Electrosurgery
Laser
Chemical methods
Topical hemostatic products
Pharmacological agents
Key Considerations in the Selection of
Hemostatic Product / Methood
Monopolar ESU
Bipolar ESU
Monopolar ESU