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Slaid 46 4. Biological ways of a final stop of bleeding

Slaid 18 The compensatory-adaptive mechanisms during acute blood loss | Slaid 19 Changes in the blood circulatory system | Slaid 20 Clinic of sharp blood loss | Slaid 27 Classification according to degree of severity (V.I.Struchkov and E.W.Lutzevich ) | Slaid 39 Ways of a temporary stop of bleedings | Mechanical ways of a final stop of bleeding |


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Biological methods of a stop of bleeding are based on application of preparations of a biological origin. They are subdivided into preparations for local application (are used or own fabrics of an organism, or means of a biological origin) and the general influence on the curtailing system.

Slaid 47 From own fabrics of an organism the lock of an epiploon or muscular tissue rich with the trombokinase are most often used. The free slice of fabrics or with preservation of the feeding vascular leg is placed and fixed to a place with the raised bleeding.

 

Biological haemo static preparations for local influence are received from gomo-or heterogeneous plasma, sometimes with collagen addition.

Thrombin is a natural component of the curtailing system and it receive from donor blood. It promotes transition of fibrinogen to fibrin. It is applied only locally in a powdery form or in solution with which impregnate gauze napkins and put to the bleeding surface.

Fibrinogen is also a natural component of blood, and receive it from plasma of blood of the donor. Under the influence of thrombin fibrinogen passes into fibrin and provides formation of a clot. Locally in pure form it isn't applied. It is used together with thrombin and is a part of local haemo static means, the fibrinous glues including in the structure and other factors of the curtailing system (calcium salt, the XIII factor of the curtailing system).

The haemo static sponge is received from native plasma of blood of the person and a tromboplastin. It is applied locally to a stop of capillary and parenchymatous bleedings during operations, and also to a stop of bleedings from bones, muscles, medium-sized vessels.

Gelaspon represents the made foam, specially processed gelatin received from pork skin. Apply to a stop of bleedings from wounds after surgeries. The preparation is located in a wound and is fixed by sterile dressing.

The biological antiseptic tampon is prepared from plasma of blood of the person with addition of gelatin, haemo static and antibacterial preparations. It is applied to treatment of capillary and parenchymatous bleedings, including from the polluted and infected wounds.

For a stop of capillary and parenchymatous bleedings the preparation Tahocomb is used. As the agents of the general impact on an organism promoting a bleeding stopping consider separate components and blood preparations. Fresh frozen plasma (FFP) is a component of the donor blood received within 4-6 hours after a blood exfuze by method of a centrifugation or an apheresis with the subsequent "shock" freezing at a temperature – 70 C. Thus labile factors of coagulation remain in a functional state.

The cryoprecipitate is a blood preparation which is used for treatment of bleedings at patients with hemophilia A, an angiohemophilia, and also serves as initial raw materials for receiving the cleared concentrate of the VIII factor of coagulating system.

Fibrinolysis inhibitors (Aprotininum, kontrikalum, Trasylolum, traneksan) are used for depression of fibrinolitic activity of a blood.


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