出血是止血不足的结果,手术部位出血过多与术后感染风险增加有关。输血和再次手术,除了增加住院时间和费用。外科医生采用一系列方法来实现止血,包括不同组成和性质的局部止血剂。止血粉是局部止血剂的一个亚组,它可用于帮助在各种情况下管理麻烦的出血。由于这项技术相对较新,并且可能不被广泛的外科界所熟知,目前尚无关于在手术中最佳使用止血粉的具体指南或建议.整个欧洲的多学科外科医生指导小组,止血和止血专家,从文学和个人经验中确定,五个关键主题。什么时候使用止血粉,使用的证据,使用的好处,各种外科专业的安全注意事项和注意事项。随后从这五个关键主题中得出了37项声明。一项在线调查被发送给128名在乳房手术中工作的大批量外科医生,妇科和产科手术,普通和急诊手术,欧洲的胸外科和泌尿外科手术评估与这些声明的一致性(共识)。如果≥75%,共识被定义为高,如果≥90%的受访者同意陈述,则共识被定义为非常高。共收到79份答复,外科专家在27份(73%)声明中达成了很高的共识,在8份(22%)声明中很高,在2份(5%)声明中没有达到。根据共识分数,指导小组提出了16项关键建议,他们认为这些建议可以通过使用止血粉剂减少术后出血及其相关并发症来改善患者结局.
Bleeding is a consequence of insufficient hemostasis and excessive bleeding at a surgical site is associated with an increased risk of post-operative infection, transfusion and re-operation, in addition to increased hospital length of stay and costs. Surgeons employ a range of methods to achieve hemostasis, including topical hemostatic agents of differing composition and properties. Hemostatic powders are a sub-group of topical hemostats, which can be used in helping as adjuncts to manage troublesome bleeding in a variety of situations. As this technology is relatively new and potentially not well known by the broad surgical community, no specific
guidelines or recommendations for the optimal use of hemostatic powders in surgery currently exist. A steering group throughout Europe of multidisciplinary surgeons, expert in hemostasis and hemostatics, identified from literature and from personal experience, five key topics. When to use hemostatic powder, the evidence for use, benefits of use, safety remarks and considerations in various surgical specialties. Thirty-seven statements were subsequently drawn from these five key topics. An online survey was sent to 128 high-volume surgeons working in breast surgery, gynaecological and obstetric surgery, general and emergency surgery, thoracic surgery and urological surgery in Europe to assess agreement (
consensus) with these statements.
Consensus was defined as high if ≥ 75% and very high if ≥ 90% of respondents agreed with a statement. A total of 79 responses were received and
consensus among the surgical experts was very high in 27 (73%) statements, high in 8 (22%) statements and was not achieved in 2 (5%) statements. Based on the
consensus scores, the steering group produced 16 key recommendations which they considered could improve patient outcomes by reducing post-operative bleeding and its associated complications using hemostatic powder.