Hemostasis, Sponges, & Drains

These type of sponges are extra absorbent, 100% cotton and four-ply USP Type III prewashed gauze. They include a four-inch, x-ray detectable element and come in a variety of sizes with or without rings. They help protect and pad delicate tissues and organs, as well as absorb fluids.

These type of sponges are made of highly absorbent, 100% cotton with an x-ray detectable element sewn into each sponge. Used on delicate structures such as nerves, the brain, and spinal cord.

A form of hemostasis that involves the use of a high frequency electric current from an ESU:

This type of chemical hemostasis is an absorbable topical hemostatic agent. Available in compacted nonwoven web or a loose, powdery form. Used in surgical procedures as an adjunct to hemostasis when control of bleeding by ligature or conventional methods are ineffective or impractical. Apply it directly to the bleeding source with dry, smooth forceps. Do not use in total joint surgery.

To restore an airtight pleural cavity and maintain negative pressure. This drain uses a water seal system connected to a source of suction (active means). A tube is inserted at the base of the pleural spaces is usually inserted at the seventh costal interspace in thoracic surgery; or in the chest near the incision site following heart surgery.

This type of drain pulls accumulated blood and fluid from the operative site. The perforated end of the catheter is placed somewhere inside a cavity in the body; that end is perforated. The external end of the catheter is connected to a device that when compressed and attached to the catheter, will exert gentle suction on the drainage catheter. Abdominal or breast surgery (Jackson-Pratt). Orthopedic surgery (Hemovac).

These type of sponges are are made of 100% USP Type III gauze with a cotton filling and are radiopaque. Used during tonsillectomies. They are available unstrung, double-strung with cotton thread for use in tight areas, or strung with a cotton tape.

Sponge swells, forming a clot, and absorbs 40-50 times its weight within 20-40 days. Used with thrombin, saline, or dry. Always squeeze air out of sponge. Don't place in intravascular compartments due to risk of embolism. Remove excess material once hemostasis is achieved.

This type of drain is used to drain the common bile duct through the abdominal wall. Placed into the common duct after exploration.

This type of chemical hemostasis is extracted from dried beef blood. Available as a powder which is reconstituted with its own dilutent. Used as a topical hemostatic agent. It accelerates coagulation of blood and controls capillary bleeding. In various types of surgery, solutions of thrombin are used in conjunction with an absorbable gelatin sponge for hemostasis. Thrombin should be used immediately after reconstitution. If necessary, it may be refrigerated for up to three hours after reconstitution.

This type of chemical hemostasis uses dehydrated hemostatic sponge
or foam available compressed, or as a powder. Dissolves as hemostasis occurs. Must be kept dry and applied dry. It is applied directly to the bleeding surface. Absorbable collagen is contraindicated in the presence of infection or in areas where blood or other fluids have pooled.

These type of sponges are made of USP Type VII gauze with filaments that become visible under x-ray. These absorb fluid and are used for the
other functions as well. These sponges should not be used for the wound dressing because they may appear as a foreign body on postoperative x-rays and might invalidate a sponge count if the patient is returned to surgery with the dressing intact.

Small staple-like devices that are placed around the lumen of a vessel.

What precaution should be taken when microfibrillar collagen is used as a hemostatic agent intraoperatively?

These are usually used in extremity surgery. Kind of like a BP cuff, they prevent venous oozing but don't obstruct arterial blood supply

A small square of Teflon material sutured over a whole in a vessel. They exert external pressure over any small needle holes to prevent bleeding and to promote clotting and are often used in cardiovascular surgery

Which type of dressing is used to prevent drying of the wound and increase the proliferation of epithelial cells?

A form of hemostasis by applying physical pressure to stop blood flow:

Used to drain fluid or blood after abdominal, urologic, thoracic, and head & neck procedures

A strand of material that is tied around a blood vessel to occlude the lumen and prevent bleeding. Large, pulsating vessels may require a transfixion suture, which is a crisscross stitch place to control bleeding from a tissue surface or small vessel when it is tied. Commonly known as a tie:

This type of chemical hemostasis is available in the form of pads or fabric. Supplied in gauze and cotton form and absorbs 7-8 times its weight in blood producing a clot. Blood clots rapidly in the presence of oxidized cellulose, forming a gel which aids in hemostasis as it becomes soaked with blood. Applied directly to the bleeding site and held in place until bleeding stops. IT should not be left in the patient if used near the spinal cord, optic nerve, or any area with serious tissue or nerve damage. This should never be used with thrombin, because it interferes with the action of thrombin. Should not be used for implantation in bone defects, such as fractures, as there is a chance of interference with callus formation.

Used for pressure ulcers, dermal ulcers, donor sites, burns, and abrasions. Bioclusive, Tegaderm, Dermicel, DuoDerm Hydrocolloids, Opsite.

Which of the following is true in handling hemostatic agents such as collagen or gelatin sponges?

Usually placed in a "stab" wound that is made adjacent to the main incision, or may be placed near an intestinal anastomosis

This type of chemical hemostasis includes chemicals that cause blood vessels to constrict. It's best to use to stop bleeding gums.

Which of the following drains allows for passive drainage of fluid from the body?

This type of thermal hemostasis cools the body's core temperature thereby decreasing cellular metabolism, thus decreasing bleeding. The body temperature must be lowered to 26°C for adults.

This type of thermal hemostasis produces local freezing of target tissue at -20°C to -60°C. Liquid nitrogen is most commonly used in with this method. It decreases the need for oxygen by the tissues thereby decreasing bleeding

Composed of a mixture of beeswax, isopropyl palmitate, and a softening agent. Provides a mechanical tamponade effect to stop oozing from cut bone surfaces. Used in some orthopedic and neuro procedures and on the sternum during heart procedures.

Clamps used to compress blood vessels. Most commonly used method of hemostasis

Used to facilitate exsanguination of blood from the distal extremity. May be used in conjunction with a tourniquet or alone. Works similar to a pneumatic tourniquet

This type of chemical hemostasis is used for sclerotherapy of hemorrhoids. Some surgeons apply it on the tip of a cotton swab to cauterize the lumen of the appendix stump as it is cut.

A form of hemostasis that involves the use of topical powders:

This type of thermal hemostasis is used to control bleeding from vascular structures, superficial bleeders, and diffuse oozing of blood. It's also used to achieve hemostasis of bone marrow.
It is a device consisting of an electrode recessed inside a probe through which gas is passed. Hemostasis is achieved as current is delivered to tissue in a direct beam of ionized gas.

These type of sponges provide blunt dissection because they absorb fluid
-Cherry: are 100% cotton and are the softest dissector.
-Peanut: are made of USP Type III gauze with a neck that allows the surgeon to adjust the hardness of the sponge.
-K-________ is made of rolled chevron, 100% cotton tape, x-ray detectable and hand stitched for strength.

This type of thermal hemostasis is often utilized in the same manner as electrosurgery for cutting and coagulating tissue and minimizing blood loss. This method provides a beam of light that is intense and concentrated and is able to cut and coagulate at the same time with minimal destruction to surrounding tissue

Which dressing would be used if the goal were hydration of tissue

This type of chemical hemostasis is a type of surgical tissue adhesive derived from human and animal blood products. The ingredients interact during application to form a stable clot. It is used to control bleeding in the area where the surgeon is working.

This type of thermal hemostasis is used to apply electrical current through the patient's tissue to cut and/or coagulate the tissue

This type of drain generally comes in four widths (¼”, ½”, ¾”, 1”) and two lengths (12” and 18”). Multiple uses such as drainage, traction, and as a tourniquet. Drainage is pulled along the outside of the drain by capillary action and gravity (passive means) into the dressing. Insertion–Usually placed through a stab wound. Drainage is pulled along the outside of the drain by capillary action and gravity into the dressing. Indications: Abdominal surgery; periotoneal cavity or skin wound

What is the term for the natural formation of fibrin. If this doesn't work then there are other methods: