A new system of blood flow block for control of bleeding in abdominal operation is composed of an abdominal magnetic blocking unit, an abdominal external electromagnet unit and other non-magnetic operation instrument. The abdominal external electromagnetic unit is placed in advance in the operation bed. The abdominal magnetic blocking unit can be placed directly on the ventral of the large vessels when need to blocking the abdominal large vessels during the operation. According to the non-contact suction characteristics of magnetic materials, the two magnetic units will attract each other and compression the vessels. Using this system for vascular occlusion does not need clear exposure and without separating vessel. There is the advantage of rapid, accurate and reliable for the system.
Abdomen ; blood supply ; Blood Loss, Surgical ; prevention & control ; Electromagnetic Phenomena ; Equipment Design ; Surgical Equipment

OBJECTIVE: To analyze the conventional application of using comprehensive hemostatic methods during the perioperative period, and the effect of autologous blood transfusion (ABT) device compared with non-negative pressure drainage on preventing blood loss and allogenic blood transfusion after primary total knee arthroplasty (TKA). METHODS: A total of 131 patients (131 knees) with severe knee osteoarthritis who underwent unilateral primary TKA by the same surgeon in Peking University Third Hospital from June 2014 to June 2015 were enrolled in this study. The patients were divided into ABT group (64 patients) and control group (67 patients). ABT devices were used for drainage and blood transfusion in the ABT group while the control group used the non-negative pressure drainage only. The results of the drainage fluid volume, the decrease of hemoglobin, the total blood loss, the hidden blood loss and blood transfusion after TKA were compared between the two groups. RESULTS: The drainage fluid volume in ABT group was significantly higher than that in control group [515 mL (80-1 610 mL) vs. 260 mL (40-670 mL), P<0.001]. The autologous blood transfusion in ABT group was 245 mL (60-1 070 mL). There were no significant differences between the two groups in the value of hemoglobin decrease 1 day after surgery (P=0.340) and 3 days after surgery (P=0.524). There were no significant differences in the total blood loss (P=0.101) and the hidden blood loss (P=0.062) between the two groups either. There were 9 patients in the 131 patients who received allogeneic blood transfusion, of whom 5 in the ABT group (5/64, the blood transfusion rate was 7.8%) and 4 in the control group (4/67, the blood transfusion rate was 6.0%), and no significant differences in the blood transfusion rate between the two groups (P=0.943). CONCLUSION With the conventional application of using comprehensive hemostatic methods during perioperative period, the ABT device did not show the effective result of controlling postoperative blood loss and failed to reduce the rate of allogeneic blood transfusion in patients with unilateral primary TKA. However, the ABT device could increase the drainage fluid volume and improve the patient's hospitalization expenses. Therefore, there is no need for routine application of ABT device in unilateral primary TKA.
Arthroplasty, Replacement, Knee ; Blood Loss, Surgical/prevention & control* ; Blood Transfusion ; Blood Transfusion, Autologous/instrumentation* ; Hemostatics ; Humans

Blood Loss, Surgical ; prevention & control ; Humans ; Intraoperative Complications ; prevention & control ; Postoperative Complications ; prevention & control ; Scoliosis ; surgery ; Superior Mesenteric Artery Syndrome ; prevention & control ; Surgical Wound Infection ; prevention & control

OBJECTIVETo investigate the application of tourniquet in burn patients during tangential excision on the extremities.

METHODSSeventy - nine burn patients who were arranged to receive tangential excision and skin grafting on the extremities were randomly divided into A and B groups. The patients in A group (n = 41) underwent the operation with the tourniquet applied continuously throughout the operation, while those in B group (n = 38), only with tourniquet applied during tangential excision. The amounts of blood loss and blood transfusion, the operation time and the take rate of grafted skin and the incidence of complications were investigated and recorded.

RESULTSThe amounts of blood loss and blood transfusion during operation in A group were 42% and 50% less than those in B group, respectively (P < 0.001). Moreover, the operation time on the upper and lower extremities in A group was much shorter (for 41% and 37%, respectively) than those in B group (P < 0.001). In addition, there was no difference of the take rate of skin graft and the incidence of subcutaneous hematoma between the two groups (P > 0.05).

CONCLUSIONContinuous tourniquet application during tangential excision on the extremities in burn patients was proved to be effective in reducing operational blood loss, blood transfusion and in shortening operation time.

Adult ; Blood Loss, Surgical ; prevention & control ; Blood Transfusion ; Burns ; surgery ; Extremities ; surgery ; Humans ; Skin Transplantation ; Tourniquets

Blood Loss, Surgical ; prevention & control ; Endoscopy ; adverse effects ; Humans ; Nose ; surgery ; Skull Base ; surgery

BACKGROUNDTourniquets used during total knee arthroplasty may lead to many complications. The aim of this study was to determine perioperative blood loss and its clinical relevance in total knee replacement surgery after applying a tourniquet.

METHODSFrom June 2009 to October 2009, 60 consecutive patients who underwent routine total knee arthroplasty were randomly divided into two groups and were treated with or without a tourniquet (30 patients/group). There were no significant differences in patient baseline characteristics between the two groups. We compared the two groups of patients in terms of intra- and postoperative bleeding, invisible or visible bleeding, and total blood loss.

RESULTSNone of the patients showed poor wound healing, lower extremity deep venous thrombosis or other complications. The amount of blood loss during surgery was lower in the tourniquet group than in the control group (P < 0.01). However, postoperative visible bleeding (P < 0.05) and occult bleeding (P < 0.05) were significantly greater in the tourniquet group than in the control group. There was no significant difference in the total amount of blood loss between the two groups (P > 0.05).

CONCLUSIONSTourniquet can reduce bleeding during total knee replacement surgery, but is associated with greater visible and invisible blood loss.

Aged ; Arthroplasty, Replacement, Knee ; methods ; Blood Loss, Surgical ; prevention & control ; Female ; Humans ; Male ; Postoperative Hemorrhage ; Tourniquets

After total knee arthroplasty, the hemoglobin descending level is not in accord with blood loss volume because of recessive blood loss. Recessive blood loss will delay wound healing, increase infected opportunity, prolong rehabilitation exercise time, effect clinical outcome, so prevention of recessive blood loss is very important. This review is about the effect of gender, age, height and weight, tourniquet, operative time and operative trauma, postoperative anticoagulation, unilateral or bilateral total knee arthroplasty, autoblood reinfusion on the recessive blood loss, which maybe is helpful for the prevention of recessive blood in total knee arthroplasty.
Arthroplasty, Replacement, Knee ; adverse effects ; Blood Loss, Surgical ; prevention & control ; Humans

Hip fracture patients preoperative and postoperative exist hidden blood loss which often affect patients' wound healing, increase the probability of infection, prolong rehabilitation exercise, influence postoperative effect. At the same time, the body's blood loss increase the activation of the blood clotting mechanism, promote the incidence of deep vein thrombosis, bleeding and deep vein thrombosis has become the main causes of high risk in hip operation. It is very important to stop bleeding, anticoagulation should not be ignored, so how to effectively deal with the prominent contradiction between the postoperative anticoagulation and bleeding or looking for a best balance has become a intractable problems in hip fracture treatment.
Anticoagulants ; therapeutic use ; Blood Loss, Surgical ; prevention & control ; Hip Fractures ; complications ; surgery ; Humans ; Intraoperative Complications ; drug therapy ; etiology ; prevention & control

OBJECTIVETo evaluate the effect of compression hemostasis with an arc-shaped transperineal incision in front of the apex of coccyx in controlling presacral venous plexus hemorrhage during rectectomy.

METHODSFrom October 2002 to October 2012, 52 patients with rectal cancer received neoadjuvant radiotherapy and developed presacral venous plexus hemorrhage during rectectomy, included 36 male and 26 female cases. Their age were 36-65 years. The hemostasis time and blood loss were analyzed.

RESULTSAll 52 patients achieved R0 resection. Of which 13 patients achieved suture hemostasis within 15 minutes, whereas 22 patients unsuccessfully treated within 15 minutes received compression hemostasis with an arc-shaped transperineal incision in front of the apex of coccyx. The median blood loss was (196 ± 44)ml and hospitalization time was (15.2 ± 1.7)days in this group. Additionally, 7 patients achieved suture hemostasis within 20 minutes except 4 patients who received compression hemostasis, with a median blood loss of (1016 ± 86)ml and hospitalization time of (21.7 ± 6.3)days. Other 6 patients achieved suture hemostasis within 30 minutes except 3 patients who received compression hemostasis, with a median blood loss of (2508 ± 73)ml and the hospitalization time was (28.8 ± 3.3)days. There was statistically significant difference of bleeding (F = 4289.562) and hospitalization time (F = 50.121) in 3 groups of patients (P = 0.000).

CONCLUSIONSOnce intraoperative presacral venous plexus hemorrhage can't be stopped timely, compression hemostasis with an arc-shaped transperineal incision in front of the apex of coccyx is an effective alternative for the patients with rectal cancer who received neoadjuvant radiotherapy.

Adult ; Aged ; Blood Loss, Surgical ; prevention & control ; Female ; Hemostasis, Surgical ; methods ; Humans ; Male ; Middle Aged ; Radiotherapy, Adjuvant ; Rectal Neoplasms ; surgery

OBJECTIVETo evaluate the perioperative clinical outcome and predictive factors for perioperative complication morbidity and mortality.

METHODSFrom August 2003 to August 2008, the data of 338 cases of hepatectomy performed in the liver transplant center of the First Affiliated Hospital of Nanjing Medical University was collected in a prospective manner. The patients' perioperative clinical risk factors and results were analyzed.

RESULTSIn the 338 hepatectomy cases, 255 patients (75.4%) underwent precise anatomical hepatectomy. The overall perioperative complication morbidity was 18.1%, while the perioperative mortality was 0.6%. In a total of 211 (62.4%) cases, the operation was carried out without blood transfusion. Univariate analysis revealed that cirrhotic liver, thrombocytopenia, blood loss in operation > 1000 ml, blood transfusion in operation and several other factors were closely related with the incidence rate of complication. Multivariate logistic regression analysis indicated that thrombocytopenia and perioperative blood transfusion were important independently predictive factors for the occurrence of perioperative complications in hepatectomy.

CONCLUSIONSPrecise hepatectomy enables patients to obtain better clinical outcome with low complication morbidity and perioperative mortality. Reducing hemorrhage is an important factor that lead to good clinical results.

Blood Loss, Surgical ; prevention & control ; Hepatectomy ; methods ; mortality ; Humans ; Intraoperative Complications ; epidemiology ; prevention & control ; Logistic Models ; Minimally Invasive Surgical Procedures ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Thrombocytopenia