Surgical Bleeding and Hemostasis

Summary

An understanding of the processes of hemostasis and thrombosis is necessary for every surgical procedure. There are a large number of biochemical events that occur in response to endothelial injury that result in the formation of a fibrin clot. Clinical bleeding may result from a defect or deficiency in any of these events or from technical error. An understanding of the specific history and physiology of a particular patient and of the intraoperative details is necessary to diagnose the etiology of postoperative bleeding. In the case discussed in this chapter, because of the large amount of bright red blood, the attending surgeon is concerned about a technical error that mandates a second trip to the operating room. The treating physician must be aware of the risks, benefits, and indications of the various treatments for postoperative bleeding.