Maintenance of surgical hemostasis therapy

Maintenance of Surgical Hemostasis Therapy

Hemostasis is an important component of the surgically induced healing process and is often accomplished through various means of therapy. It refers to the prevention of bleeding, either actively or passively, during surgery, childbirth, or a traumatic injury. Hemostatic therapies are used in a variety of medical procedures to stop loss of blood and to decrease total time in the operating room. They help speed healing of tissue and conserve blood.

The maintenance of surgical hemostasis therapy is essential to ensure patient safety, reduce blood loss, and promote a successful healing process. The most important part of surgical hemostasis therapy is preoperative planning and intraoperative coordination between the surgeon and the anesthesiologist.

Planning: pre-op planning should include detail information about patient health and surgery amount, type of procedure, skin prep type, methods for hemostasis interruption, and post-op treatment.
Anesthesia: options should be discussed between the anesthesiologist and the surgeon before hemostasis is interrupted. Intraoperative treatment should be tailored to the specific patient. Isotonic fluids, central venous pressure, inotropic support, and preload manipulation should all be optimized.
Hemostatic Agents: selection of appropriate agents depends on the type of hemostatic procedure and patient characteristics. The use of a combination of agents can lead to greater effectiveness and more consistent outcomes.
Coagulation Management: requires an understanding of the clotting process and the relationship between clotting factors, platelets, and other coagulation parameters. The use of continuous monitoring and adjustment of parameters can help minimize the risk of adverse events.
Bleeding Control: various techniques, including direct pressure, topical hemostatic agents, suturing, or mechanical devices can be used to control bleeding. Depending on the location, intensity, and extent of the bleeding, the best approach should be selected.
Monitoring: monitoring of surgical hemostasis should include a period of observation following the procedure. Blood loss should be monitored closely and corrective action taken if necessary.

The maintenance of surgical hemostasis therapy requires knowledge and experience. The risk of adverse events can be minimized by proper preoperative planning and the use of appropriate techniques. Patients should be informed of expected outcomes prior to the treatment in order to assess the likelihood of success and minimize the risk of complications.