Maintaining Hemostasis in Surgery

Hemostasis is the body’s natural objective to maintain homeostasis by controlling blood loss by coagulation, constriction of a blood vessel or to an organ. The human body needs to sustain a certain amount of blood volume in order to properly function. Blood loss can be fatal to the patient and it’s up to the surgical team to maintain the hemostasis of the individual.

The human body naturally has ways that is can maintain blood loss and this is preferred method to achieve hemostasis. Coagulation of the blood is the body’s first line of defense in forming clots form upon the transformation of fibrinogen to fibrin, and its second line of defense is the platelet plug. One other way the body naturally accomplishes hemostasis is through the autonomic constriction of the blood vessels to stop the blood flow.

There are three main ways to achieve hemostasis during a surgical intervention, mechanical, chemical and thermal. Mechanical methods include: sutures, ligatures, direct pressure and sponge sticks. Chemical techniques include using compounds like Gelfoam, Acitene, silver nitrate, etc . Thermal ways include cautery with a single or bipolar tips, lasers or cryotherapy.

If hemostasis is interrupted during a surgical intervention and they patient starts to hemorrhage, there are various ways hemostasis can be returned. The patient can receive blood from another person (homologous) or blood can be donated by the patient prior to the procedure (autologous). The patient may also receive blood products that include plasma, platelets or packed red blood cells. Blood can also be recycled during the operation from the suction canister or removed from sponges using saline, ran through a transfusion machine and given back to the patient.

There are some circumstances where blood can’t be given to a patient, if it’s dirty case and the blood has been contaminated by gastric or enteric contents, if the patient has a local or systemic infection or if cancer is present. In some...