An improved nonsuture method for portacaval anastomosis in the rat.

A nonsuture technique is described for performing portacaval anastomoses in rats. Improvements include reduced clamping time on critical vessels, reduced blood loss, uniformly patent anastomoses, easily manufactured buttons, and decreased mortality rates. The new procedure allows a single operator to perform 25 such operations per day, thus substantially increasing the availability of these animals for studies in hepatic metabolism following portacaval anastomoses.

Postpartum hemorrhage and reevaluation of uterine packing.

Postpartum hemorrhage, occurring in 153 patients, is categorized according to etiology, predisposing conditions, and severity. Ruptured uterus is considered as a cause of postpartum hemorrhage, with an incidence of 7.1% overall and 11.9% in patients with severe hemorrhage. The effectiveness and complications of the uterine pack, used in 33 patients, are evaluated.

External counterpressure to control postoperative intra-abdominal hemorrhage.

The effectiveness of the G-suit controlling massive postoperative intra-abdominal hemorrhage was studied in twenty-eight patients whose diffuse bleeding could not be controlled during operation. Most patients had developed deficiencies of platelets and clotting factors due to dilution, and in addition three had documented disseminated intravascular coagulation. After application of the G-suit, hemorrhage stopped in nineteen patients, allowing the replacement of platelets and clotting factors in patients with deficiencies and the administration of heparin to three patients with disseminated intravascular coagulation. After an average of twenty-one hours the G-suit was removed without rebleeding in seventeen patients. The major cause of G-suit failure was an arterial source of intra-abdominal bleeding. Application of the G-suit had no adverse effect on renal function in at least half the patients; urinary output declined in on third. Mos patients experienced respiratory impairment and some had ischemic skin lesions. The G-suit is frequently effective in halting postoperative intra-abdominal hemorrhage, allowing correction of acquired coagulopathies with acceptably few complications. Its use does not replace the need for proper surgical hemostasis.

Partial cardio-pulmonary bypass in peripheral vascular surgery: case reports.

Two cases of aneurysmatic vascular lesions (a large cranio-encephalic angiodysplasia with arterio-venous communications and a post-traumatic aneurysm of the vertebral artery) are reported; both were of a very difficult surgical approach and were successfully treated with the use of extra-corporeal circulation. The partial cardiopulmonary bypass, with femoro-femoral cannulation, allowed complete recovery of the lost blood, controlled hypotension, and a certain degree of hypothermia. These factors were decisive for the good outcome of the operations.

[Klobusitsky's hemocoagulase in plastic surgery]. / L'emocoagulasi Klobusitzky in chirurgia plastica

Klobusitzsky haemocoagulase, a haemostatic drug obtained from snake poison, was administered prior to surgery in 35 cases of harelin, cleft palate, hypospadias and deviation of the nasal septum. Treatment was carried out from 2 to 6 days, doses and i.m. or i.v. administration being determined on the basis of age. Objective and subjective results were good, particularly in cases of cleft palate and septum deviation. In all cases, there was a significant shortening of bleeding time after treatment with the drug.