Mechanical ways of a final stop of bleeding

It is necessary to carry to final ways of a stop of bleeding above the given mechanical methods with use of the pressing bandage, effective at capillary and venous bleeding, and the hard tamponade of a wound used for a stop of bleeding not only from wounds of soft fabrics but also at bleeding from parenchymatous bodies. Application of a probe obturator of Blackmore is based on the same principle. It is used for a bleeding stop from varicose expanded veins of a gullet. The probe is entered into a stomach, the lower cuff which is fixed to a cardia at its pulling up is inflated. Then the top cuff which squeezes the bleeding veins of a gullet is inflated and leads to a bleeding stop.

Twisting of the damaged vessel. At insignificant bleedings from vessels of small caliber sometimes apply twisting of a vessel in one party, having captured him a clip or tweezers (for example, a bleeding stop from small venous branches at a phlebectomia). Thus the wall of a vessel is rolled, collapses intim and in its gleam blood clot is formed.

Flashing or bandaging of a vessel in a wound. On the bleeding vessel the styptic clip of Billroth for a temporary stop of bleeding is imposed. Then on a vessel the ligature for a final stop of bleeding is imposed. For bandaging use silk, kapron both other resolving and not resolving synthetic threads. For bigger reliability of a hemostasis on large vessels two ligatures are imposed: one usual, and another with a vessel flashing (the needle with a thread passes on diameter of a vessel, and then one and other its semi-circles tie).

Bandaging of vessels on an extent. It is applied at strong bleedings when it isn't possible to find and tie up the damaged vessel in a wound. In this regard the vessel is allocated and ties above a place of its damage to not changed fabrics. Also arrive at late secondary arrosive bleeding from a purulent wound as bandaging in a purulent wound is unreliable and recurrence of bleeding can develop.

Slaid 43 Clipping of the bleeding vessels metal brackets. It is used when bandaging of a vessel is difficult or impossible, for example, at various endoscopic operations, for a bleeding stop from stomach ulcer.

Imposing of a vascular seam. At damage of the main vessels imposing of a ligature dangerously because of possible development of a necrosis therefore apply a vascular seam. It is imposed at regional damages of vessels or at full crossing of a vessel. In the latter case vessels connect "the end in the end". Vascular clips and atraumatic monofilamentny sutural material are necessary for imposing of a vascular seam.

Imposing of a vascular artificial limb (alloplastic). At full crossing of a large vessel and existence of traumatic defect imposing of a vascular seam is impossible therefore use for defect replacement an autovien (a big hypodermic vein of a hip or a superficial vein of a forearm) or synthetic artificial limbs.

At bleeding, developing from remote vessels and impossibility of its stop in the regular way, use an embolization of the injured artery. For this purpose through an angiographic catheter enter various designs acting as the peculiar stopper corking a vessel into the necessary vessel.

Sealing of vessels. It is applied to a bleeding stop from vessels of spongy substance of bones, for example, at cranial trepanation. For sealing in the bleeding surface of a spongy bone rub sterile wax or the special paste consisting of paraffin, wax and vaseline.

Slaid 44

Дата добавления: 2015-11-14