関: hemostat、hemostatic、hemostatic drug、hemostatics

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a surgical instrument that stops bleeding by clamping the blood vessel (同)haemostat

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〈U〉止血剤 / 〈C〉(手術用の)止血鉗子(しけつかんし)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/07/27 19:49:20」(JST)

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For substances that stop bleeding, see hemostatic agent.

Hemostats, curved and straight tip

A hemostat (also called a hemostatic clamp, arterial forceps, or pean after Jules-Émile Péan) is a vital surgical tool used in many surgical procedures to control bleeding. For that reason it's common to see the initial incision lined with hemostats closing blood vessels awaiting ligation during the initial phases of surgery. Hemostats belong to a group of instruments that pivot (similar to scissors, and including needle holders, tissue holders and various clamps) where the structure of the tip determines the function.

The hemostat has handles that can be held in place by their locking mechanism. The locking mechanism is typically a series of interlocking teeth, a few on each handle, that allow the user to adjust the clamping force of the pliers. When locked on, the force between the tips is approximately 40 N (9 lbf).

Hemostats are part of the first aid kit carried by combat medics and paramedics.

History[edit]

The earliest known drawing of a pivoting surgical instrument dates back to 1500 BC on a tomb at Thebes, Egypt. Later Roman bronze and steel pivot-controlled instruments were found in Pompeii. In the ninth century AD Albucasis made illustrations of pivoting instruments for tooth extraction^{[citation needed]}.

The concept of clamping a bleeding vessel with an instrument before tying it off is generally attributed to Galen (second century AD). This method of hemostasis was largely forgotten until it was rediscovered by the French barber-surgeon Ambroise Paré in the 16th century. He made the predecessor to the modern hemostat and called it the Bec de Corbin (crow's beak) (see image below). With it he could clamp a bleeding vessel before securing it with a ligature.

Bec de Corbin

The modern hemostat is credited to several persons, the foremost of which is Jules-Émile Péan. Later surgeons (i.e. William Halsted) made alterations to the design.

List of hemostats[edit]

Satinsky clamps are designed to partially occlude the wall of a vessel over a distance
Thornton
Kocher
Kelly
Crile
Halsted
Carmalt

External links[edit]

Hemostats on Wikisurgery

English Journal

The efficacy of absorbable polysaccharide haemostats in wound healing.

Sonmez E1, Turkdogan KA, Civelek C, Dur A, Gulen B, Karayel E, Gucin Z, Sogut O.
Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis.Blood Coagul Fibrinolysis.2015 Jan;26(1):50-3. doi: 10.1097/MBC.0000000000000177.
Wound healing represents an ancient problem for humans, and various materials and methods have been tried for wound dressing. A dressing should protect against infection and shorten healing; moreover, it should not cause tissue damage and should be nonallergenic, cost effective and easy to apply. Th
PMID 25158986

Development of haemostatic decontaminants for the treatment of wounds contaminated with chemical warfare agents. 1: Evaluation of in vitro clotting efficacy in the presence of certain contaminants.

Hall CA1, Lydon HL, Dalton CH, Chipman JK, Graham JS, Chilcott RP.
Journal of applied toxicology : JAT.J Appl Toxicol.2014 Aug 15. doi: 10.1002/jat.3019. [Epub ahead of print]
The treatment of penetrating, haemorrhaging injuries sustained within a hazardous environment may be complicated by contamination with toxic chemicals. There are currently no specific medical countermeasures for such injuries. Haemostats with an absorbent mechanism of action have the potential to si
PMID 25131713

Polyglycolic acid sheet with fibrin glue potentiates the effect of a fibrin-based haemostat in cardiac surgery.

Kasahara H1, Hayashi I.
Journal of cardiothoracic surgery.J Cardiothorac Surg.2014 Jul 8;9:121. doi: 10.1186/1749-8090-9-121.
BACKGROUND: Hemorrhage from the left ventricle can be critical and sutureless repair using a fibrin-based haemostat (TachoComb) is one effective option. When active hemorrhage is not controlled by the haemostat, we have used a polyglycolic acid (PGA) sheet and fibrin glue in addition. Here we invest
PMID 25002331

Japanese Journal

皮下脂肪結合組織細片によりシールされた心大血管用パッチ　内膜治癒の検討:―内膜治癒の検討―

梶原博一,野一色泰晴,平野克典,市川由紀夫,石井正徳,小菅宇之,孟真,山本賢二,近藤治郎,松本昭彦
人工臓器 22(2), 398-402, 1993
皮下脂肪結合組織細片を用いて人工血管の網目をシールする方法を開発し、出血に対しての安全なパッチ材料を作製した。今回、このパッチ材料の内膜治癒を検討した。方法としては、皮下脂肪結合組織を細片として高有孔性ダクロン製人工血管内に圧注入し、組織片により目詰まりさせ、これと対照のpreclotting法と隣合わせのパッチを作製した。これを成犬右室流出路にパッチ縫着し、2週間後、摘出し、肉眼的、光顕的に観察 …
NAID 130001732710