BLOODLESS MEDICINE AND SURGERY: SOME OF THE METHODS

BLOODLESS MEDICINE AND SURGERY: SOME OF THE METHODS

Fluids: To maintain blood volume and prevent hypovolemic shock, the Ringer’s lactate solution, dextran or hydroxyethyl starch can be used. Some fluids now being investigated can transport oxygen.

Drugs: Genetically engineered proteins can stimulate the production of red blood cells (erythropoietin), blood platelets (interleukin-11), and various white blood cells (GM-CSF, G-CSF). Other medications greatly reduce blood loss during surgery (aprotininm antifibrinolytics) or help to reduce acute bleeding (desmopressin).

Biological haemostats: Collagen and cellulose woven pads are used to stop bleeding by direct application. Fibrin glues and sealants can plug puncture wounds or cover large areas of bleeding tissue.

Blood recovery: Salvaging machines recover blood that is lost during surgery or trauma. The blood is filtered, and can be returned to the patient in a closed circuit. In extreme cases, litres of blood can be recovered using such a system.

Surgical techniques: Thorough operative planning, including consultation with experienced clinicians, helps the surgical team to avoid complications. Prompt action to stop bleeding is essential. Delays greater than 24 hours can greatly increase patient mortality. Dividing large surgeries into several smaller ones decreases total blood loss.

Surgical tools: Some devices cut and seal blood vessels simultaneously. Other devices can seal bleeding on large areas of tissue. Endoscoscopic and minimally invasive instruments allow surgeries to be performed without the blood loss associated with large incisions.

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