๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Hemostasis
Hemostasis
Achieving adequate hemostasis prior to wound closure is an absolute requirement.
Experience is very helpful in distinguishing between low-level wound-edge oozing that may resolve with suturing and pressure, and true bleeding that should be addressed with aggressive hemostatic measures. There is a delicate balance between mitigating the risk of hematoma formation and overly desiccating wound edges that may impair healing over the long and short terms. Larger vessels should be clamped and ligated, rather than treated with electrosurgical approaches, in order to minimize the risk of bleeding in the acute postoperative period. Bipolar forceps may be useful, though they are not necessary.
Bleeding should always be addressed under direct visualization, and skin hooksโ usually used as a pair to tent up the overlying epidermis and dermisโmay be very helpful for this purpose.