New concept and new surgical instrumentation to control haemorrhages in emergency surgery

Objective. Haemorrhage is a major cause of mortality and morbidity in surgery. It is responsible for half of the casualties on the battlefield and represents the second cause of mortality in civilian trauma surgery. In some cases, surgeons may face limits of the conventional, haemostatic techniques. A new haemostatic concept based on the compression of the hemorrhagic wounds by depressive suction has been invented and copy-written at the University Hospital of Grenoble in France. This concept led to the creation and development of new haemostatic devices. We present herein their first experimental result, their first feasibility study, and their first clinical applications in trauma surgery. Material and methods. The haemostatic device is comprised of a half spherical, silicon suction cup and a rigid pillar on the central axis. The size of the cup is variable to adapt to the different wounds sizes. When a depression is transmitted into the cup, it results in a compression of the wound by the central pillar. Results. The experimental study was conducted on animal models (sheep). The aim of the study was to perform some experimental hemorrhagic wounds of the heart, the major vessels, and the liver and to control the bleeding with the new haemostatic, suction devices. The results were favourable and a feasibility study could be started on human patients. The feasibility study was conducted on a cohort of 30 patients operated in elective cardiac surgery including extra corporeal circulation at the University Hospital of Grenoble. The haemostatic devices were used to stop the bleeding occurring on the right atrium and aorta after removal of the cannulation.