Hemostasis Techniques Research Articles

Post-closure Technique for Access Hemostasis During Emergency Endovascular Repair in Ruptured Abdominal Aortic Aneurysms: Technical Note on a Preliminary Experience.

To describe the downsizing post-closure technique for access hemostasis during emergency endovascular repair (EVAR) in ruptured abdominal aortic aneurysms (RAAA). A cohort of eight patients underwent emergency EVAR through 16 femoral access sites for infrarenal RAAA. The downsizing post-closure technique, which involves a reduction in the size of the large-bore access by advancing a 10F sheath, was consistently applied. Technical success was defined as complete hemostasis without a bailout intervention. Primary outcome measure was the incidence of access-related complications. Secondary outcome measures included manual compression time, hemostasis time, hospital stay, additional use of Proglide, and the 30-day mortality rate. The techniqueresulted in a 100% success rate (mean age: 69.5 ± 11.7years; 75% males). The mean arterial sheath size was 18.1 ± 1.9F. The mean manual compression time was 3.6 ± 1.2min, and the mean hemostasis time was 6.8 ± 1.4min. No patients required additional use of Proglide, and no access-related complications were observed. The 30-day mortality rate was 12.5%. The downsizing post-closure technique may offer an alternative for access hemostasis during emergency EVAR for RAAA. However, further evaluations through larger comparative studies are required.

Robot-assisted radical prostatectomy haemostasis techniques and outcomes.

Robot-assisted radical prostatectomy haemostasis techniques and outcomes.

SURGICAL CARE FOR INJURIES TO THE PELVIC AND INTRAPARATIC ORGANS

Summary. The goal. In 2/3 of victims with closed abdominal trau­ma, there are injuries to internal organs and the skeleton with the development of retroperitoneal hematoma and bleeding. The mortality rate in victims with injuries to retroperitoneal structures and pelvic organs reaches 60%. The presence of blood loss raises the question for surgeons and traumatologists of the need to provide emergency surgical care, the purpose of which is to stop bleeding and eliminate its consequences after injury. Materials and methods. 114 victims (aged 19-70 years and older) with traumatic injuries of the pelvic organs and retroperitoneal space, accompanied by massive blood loss, who were treated in the traumatology department and the polytrauma department of the Kharkiv City Emergency Hospital named after Prof. O. I. Meshchaninov, as well as in the department of emergency surgery, traumatic shock, anesthesiology, resuscitation and intensive therapy of the State Institution «V. T. Zaitsev Institute of Internal Medicine of the National Academy of Sciences of Ukraine» were examined. The results. Urgent examinations were performed on all victims. Radiological methods were used. Thus, with the help of a survey radiograph of the abdominal cavity, not only fractures of the pelvic bones were detected, but also the presence of free gas in the abdominal cavity and accumulation of gas in the retroperitoneal space, signs of retroperitoneal hematoma, deformation of the urinary bladder by retroperitoneal hematoma. Ultrasound helped to establish the presence of a massive retroperitoneal and paranephral hematoma. Conclusions. The use of the balloon hemostasis technique to tem­porarily stop bleeding allows you to reduce the rate of blood loss, the growth of retroperitoneal hematoma, and prevent the development of purulent-septic complications, as well as improve the conditions for further assistance and the sequence of its implementation, depending on the extent of the injury.

Two different hybrid vascular access closure strategies post transcatheter aortic valve implantation

Abstract Background The hybrid strategy combining plug-based and suture-based vascular closure devices (VCD) was introduced as a promising technique for vascular access hemostasis after transcatheter aortic valve implantation (TAVI) with satisfactory outcomes. However, data comparing two plug-based VCDs each in the combination with a suture-based VCD, namely ProGlide/FemoSeal (P/FS) with ProGlide/AngioSeal (P/AS) VCDs, is still lacking. Aim To compare the 30-day outcome of the hybrid strategy using P/AS versus P/FS for vascular access site closure after TAVI. Methods A retrospective single Centre observational study included 608 patients recruited from a prospective TAVI registry between 2016 and 2022. The composite endpoint was defined as any VCD related major vascular complications and/or bleeding more than type 1 according to Valve Academic Research Consortium (VARC-3) criteria. Results The current study reported a significantly higher rate of composite endpoint in P/AS group, which was driven by higher rate of major bleeding (5.4% vs 1.4%, p=0.036). We also found a higher rate of VCD related minor bleeding in P/AS group (16.3% vs 8.1%, p=0.013). Successful access site hemostasis was achieved in 83.1% of P/FS group versus 71.7% in P/AS group (p=0.006). The presence of anterior wall calcification at the access site was significantly associated with the composite endpoint (adj OR 2.49; 95% CI (1.08 – 5.75), p=0.032). Conclusions The hybrid strategy for large bore vascular access closure using P/FS showed a potentially better 30-day outcomes compared with P/AS. The presence of anterior calcification at the access site carries a significant risk of VCD related complications.

Impact of robotic surgery on postoperative gastrointestinal dysfunction following minimally invasive colorectal surgery: incidence, risk factors, and short-term outcomes

AimPostoperative gastrointestinal dysfunction (POGD) is a common complication following colorectal surgery. This study aimed to investigate the incidence and risk factors of POGD after minimally invasive surgery and to assess the relationship between robotic surgery, POGD, and their outcomes.MethodPatients who had undergone minimally invasive colorectal surgery at our institution between July 2018 and November 2023 were retrospectively enrolled. POGD was diagnosed based on the presence of two or more intestinal symptoms within 72 h or more after surgery. Risk factors were identified through regression analyses, and the impact of POGD on outcomes was assessed using linear regression.The association between those factors was assessed using subgroup analysis and hierarchical regression.ResultsA total of 226 patients were included in the analysis, including 33 with POGD. POGD occurred in 14.6% of patients, with a lower incidence in robotic surgery (7.3%) than in laparoscopic surgery (19.8%). Multivariate analysis indicated that robotic surgery had a protective effect, while blood loss exceeding 50 ml was an independent risk factor for POGD. POGD was also correlated with longer length of stays and higher costs. The association between POGD, length of stay, and cost varied depending on the surgical platform. Robotic surgery exacerbated the effect of POGD on short-term outcomes, which aligned with the observed significant interaction effect.ConclusionPOGD remains a prevalent postoperative disease. Preventive strategies, including meticulous hemostasis techniques and robotic surgery, should be prioritized by healthcare professionals to reduce POGD risk, improve short-term outcomes, and preserve healthcare resources.

ProGlide-AngioSeal versus ProGlide-FemoSeal for vascular access hemostasis posttranscatheter aortic valve implantation.

The hybrid strategy combining plug-based and suture-based vascular closure devices (VCD) was introduced as a promising technique for vascular access hemostasis after transcatheter aortic valve implantation (TAVI) with satisfactory outcomes. However, data comparing two plug-based VCDs each in the combination with a suture-based VCD, namely ProGlide/AngioSeal (P/AS) with ProGlide/FemoSeal (P/FS) VCDs, is still lacking. To compare the 30-day outcome of the hybrid strategy using P/AS versus P/FS for vascular access site closure after TAVI. A retrospective single-center observational study included 608 patients recruited from a prospective TAVI registry between 2016 and 2022. The composite endpoint was defined as any VCD-related major vascular complications and/or bleeding more than type 1 according to Valve Academic Research Consortium criteria. The current study reported a significantly higher rate of composite endpoint in P/AS group, which was driven by a higher rate of major bleeding (5.4% vs. 1.4%, p = 0.036). We also found a higher rate of VCD-related minor bleeding in P/AS group (16.3% vs. 8.1%, p = 0.013). Successful access site hemostasis was achieved in 71.7% of P/AS group versus 83.1% in P/FS group (p = 0.006). The presence of anterior wall calcification at the access site was significantly associated with the composite endpoint (adj odds ratio 2.49; 95% confidence interval (1.08-5.75), p = 0.032). The hybrid strategy for large bore vascular access closure using P/FS showed a potentially better 30-day outcomes compared with P/AS. The presence of anterior calcification at the access site carries a significant risk of VCD-related complications.

Horner's Syndrome as a Complication of Tonsillectomy: Comprehensive Literature Review.

Horner's syndrome, though very rare, is a recognized complication following tonsillectomy, as presented in this case report of a 4.5-year-old girl. She developed Horner's syndrome after a tonsillectomy, which was performed using cold steel technique and bipolar diathermy for hemostasis. The patient exhibited symptoms such as ptosis, miosis, and anhidrosis on the left side, detected following a secondary post-tonsillectomy hemorrhage that required surgical intervention. No improvement in Horner's syndrome was noted after 3 months. Our review of the literature revealed 15 documented cases of Horner's syndrome as a complication of tonsillectomy, with an increase in recent years possibly due to the advancements in surgical techniques and heightened awareness of the condition. Interestingly, Horner's syndrome occurred with a wide range of surgical methods, indicating that the etiology is likely multifactorial, involving factors such as surgical technique, anatomical variations, and the extent of cauterization. This report emphasizes the need for caution in the application of modern hemostatic techniques, advocating for a balanced approach that considers traditional methods like ligation and suturing, which may reduce the risk of such complications. Continuous reporting and further research are crucial to better understanding the mechanisms behind Horner's syndrome following tonsillectomy and improving patient outcomes.

Chinese expert consensus on surgical treatment of hypertensive intracerebral hemorrhage based on parafascicular approach(2024 edition)

Hypertensive intracerebral hemorrhage (HICH) is one of the main causes of death and disability in Chinese people. Surgical treatment can reduce the mortality rate of patients with HICH, but cannot improve functional prognosis. Therefore, promoting the neurological function recovery of surviving patients has become the focus of treatment for HICH. The corticospinal tract (CST) is the main descending fiber bundle that maintains motor function, and its integrity determines the degree of motor function recovery. Therefore, reducing CST injury is expected to improve motor dysfunction in patients with supratentorial deep HICH. Standardizing the indications, surgical strategies, and operational procedures for minimally invasive surgical treatment via the parafascicular approach can achieve maximum hematoma clearance and minimal white fiber bundle damage, which is beneficial for promoting the recovery of white matter fibers and improving neurological function prognosis. The Chinese Congress of Neurological Surgeons of Chinese Medical Doctor Association, the Neurosurgery Branch of the Chinese Medical Association, the Intracerebral Hemorrhage Minimally Invasive Surgical Treatment Branch of the Chinese Stroke Association, and the Stroke Branch of the Chongqing Medical Association organized relevant domestic experts to systematically query and evaluate existing relevant research evidence, refer to relevant international consensus and guidelines, and combine national conditions and domestic needs. A total of 31 recommendations were formed for preoperative examination, surgical indications, intraoperative positioning, surgical methods, hemostasis techniques, and perioperative management for surgical treatment of HICH based on white matter fiber protection, hoping to provide important reference for the surgical treatment of HICH.

Efficacy and safety of over-the-scope-clips in the therapy of acute nonvariceal upper gastrointestinal bleeding: Meta-analysis.

Acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) is a frequent life-threatening acute condition in gastroenterology associated with high morbidity and mortality. Over-the-scope-clip (OTSC) is a new endoscopic hemostasis technique, which is being used in ANVUGIB and is more effective. To summarize and analyze the effects of the OTSC in prevention of recurrent bleeding, clinical success rate, procedure time, hospital stay, and adverse events in the treatment of ANVUGIB, to evaluate whether OTSC can replace standard endoscopic therapy as a new generation of treatment for ANVUGIB. The literature related to OTSC and standard therapy for ANVUGIB published before January 2023 was searched in PubMed, Web of Science, EMBASE, Cochrane, Google, and CNKI databases. Changes in recurrent bleeding (7 or 30 days), clinical results (clinical success rate, conversion rate to surgery, mortality), therapy time (procedure time, hospital stay), and adverse events in the OTSC intervention group were summarized and analyzed, and the MD or OR of 95%CI is calculated by Review Manager 5.3. This meta-analysis involved 11 studies with 1266 patients. Total risk of bias was moderate-to-high. For patients in the OTSC group, 7- and 30-days recurrent bleeding rates, as well as procedure time, hospital stay, and intensive care unit stay, were greatly inhibited. OTSC could significantly improve the clinical success rate of ANVUGIB. OTSC therapy did not cause serious adverse and was effective in reducing patient mortality. OTSC may provide more rapid and sustained hemostasis, and thus, promote recovery and reduce mortality in patients with ANVUGIB. In addition, the safety of OTSC is assured.

Innovative hemostasis technique for cesarean section in placenta previa: A retrospective study.

To evaluate hemostatic efficacy, complications, and subsequent pregnancy outcomes in women with placenta previa who underwent combined vertical compression sutures in the lower uterine segment and intrauterine balloon tamponade (Hot-Dog method) to achieve hemostasis after cesarean section. We retrospectively reviewed data for 117 women with singleton pregnancy diagnosed with placenta previa who underwent cesarean section between 29 and 38 weeks' gestation. Treatments were as follows: (1) conventional-intravenous oxytocin administration after placental detachment and suturing of bleeding points at the detachment site as needed (conventional group) (n = 47). (2) Intrauterine balloon tamponade alone (balloon group) (n = 41). (3) Vertical compression sutures + intrauterine balloon tamponade (Hot-Dog group) (n = 29). The placenta accreta spectrum prevalence was significantly higher in the balloon and Hot-Dog groups versus the conventional group. The prevalence of anteriorly located placenta was significantly higher in the Hot-Dog versus balloon groups. Intraoperative and total blood loss were significantly higher in the Hot-Dog versus conventional groups. Postoperative blood loss was significantly lower in the Hot-Dog versus balloon groups. Fewer additional procedures for managing postoperative hemorrhage were required in the Hot-Dog versus conventional and balloon groups. The number of subsequent pregnancies in the conventional, balloon, and Hot-Dog groups was 11 (23.4%), 8 (19.5%), and 4 (13.8%), respectively; all resulted in live births at term without serious obstetric complications. The Hot-Dog method is a straightforward and safe hemostasis technique for placenta previa that preserves fertility and controls severe bleeding.

A case series of forearm compartment syndrome complicating transradial cardiac catheterization

BackgroundAcute compartment syndrome following a transradial coronary approach is rare. However, as the incidence of coronary arterial disease increases due to lifestyle factors and multiple comorbidities, transradial coronary angiography has become more common for diagnostic and therapeutic purposes in cardiovascular centers. Despite its rarity, we encountered two cases of acute compartment syndrome within a 1-week interval in the cardiology unit of a tertiary hospital.Case presentationThe first case involved a 75-year-old woman diagnosed with non-ST elevation myocardial infarction (NSTEMI). A coronary angiogram was performed via an uncomplicated right radial artery puncture. Following the procedure, the patient experienced significant swelling in the right forearm. An emergency fasciotomy release of the right forearm was conducted, revealing a gushing hematoma upon entering the flexor compartment. Fortunately, the wound healed well two months postoperatively with no functional deficits. In the second case, an 80-year-old man presented with severe angina pectoris upon exertion and was diagnosed with NSTEMI. The following day, he developed compartment syndrome in the left forearm, necessitating an emergency fasciotomy. Intraoperative examination revealed muscle bulging within the forearm compartments accompanied by extensive hematoma. Postoperatively, a deranged coagulation profile caused oozing from the wound. However, since there was no arterial bleeding, a compression dressing was applied. This led to a gradual drop in hemoglobin levels and worsened his heart condition. Despite resuscitative efforts and attempts to correct the coagulopathy, the patient experienced cardiorespiratory arrest and succumbed to ischemic heart disease in failure.ConclusionClinicians must remain vigilant in identifying this potentially limb-threatening condition. Patients with pre-existing anticoagulant therapy and underlying atherosclerotic disease are at a higher risk of bleeding complications. Implementing effective hemostasis techniques and promptly managing swelling can help prevent the occurrence of compartment syndrome. Timely assessment and maintaining a high level of clinical suspicion are paramount. If necessary, early consideration of decompressive fasciotomy is essential to avert catastrophic outcomes.

Endoscopy in the diagnosis and treatment of gastroduodenal bleedings in patients with pancreatitis

The OBJECTIVE was to study the possibilities of endoscopy in the diagnosis and treatment of bleedings in patients with pancreatitis.METHODS AND MATERIALS. Based on the analysis of 135 patients with pancreatitis complicated by gastroduodenal bleeding, we determined the location and possibilities of endoscopic hemostasis. The article analyzes 2 groups of patients. The first group (64 patients with acute pancreatitis and gastroduodenal bleeding). The second group (71 patients with chronic pancreatitis complicated by gastroduodenal bleeding). The article shows features of endoscopic examination of patients with pancreatitis complicated by gastroduodenal bleeding.RESULTS. The leading method of stopping bleeding in these groups of patients is endoscopic hemostasis.CONCLUSION. The choice of endoscopic hemostasis method depends on the cause and nature of the bleeding. The developed technique of endoscopic hemostasis has reduced the mortality rate from gastroduodenal bleeding in patients with pancreatitis to 3 %.

Predictors of renal function deterioration at one year after off-clamp non-renorrhaphy partial nephrectomy.

Preservation of renal function is an important goal in renal cell carcinoma-related surgery. Although several case-dependent techniques for renal pedicle clamping and hemostasis have been used, their effects on long-term renal function are controversial. The clinical records of 114 patients who underwent off-clamp non-renorrhaphy open partial nephrectomy at our hospital were retrospectively reviewed. Perioperative estimated glomerular filtration rate (eGFR) preservation was calculated, and predictors of eGFR decline 12 months post-surgery and overtime deterioration of renal function were identified using a multivariate regression analysis. The median patient age was 65 years, and the median tumor size was 27 mm. The mean eGFR preservation at 1, 3, and 12 months post-surgery were 90.1%, 89.0%, and 86.9%, respectively. eGFR decline at 1 and 3 months were associated with poor eGFR preservation at 12 months with the odds ratio (95% confidence interval (CI)) of 1.97 and 3.157, respectively. Multivariate regression analyses revealed that tumor size was an independent predictor of eGFR decline at 12 months. Among 65 patients with eGFR preservation over 90% at 1 month post-surgery, eGFR value of 28 patients deteriorated below 90% at 12 months post-surgery compared with preoperative eGFR. Tumor size and eGFR preservation at 1 month were independent predictors of long-term renal function deterioration. Tumor size predicted eGFR decline 12 months post-surgery. Only a mild decline in eGFR was observed between 3 and 12 months after open partial nephrectomy. Tumor size and eGFR preservation at 1 month predicted the deterioration of renal function over time.

AB183. SOH24AB_058. The effectiveness of a novel haemostasis technique in thyroid and parathyroid surgery: an observational study

AB183. SOH24AB_058. The effectiveness of a novel haemostasis technique in thyroid and parathyroid surgery: an observational study

A randomized controlled trial comparison of PTEBL and traditional teaching methods in “Stop the Bleed” training

BackgroundThe Stop the Bleed (STB) training program was launched by the White House to minimize hemorrhagic deaths. Few studies focused on the STB were reported outside the United States. This study aimed to evaluate the effectiveness of a problem-, team- and evidence-based learning (PTEBL) approach to teaching, compared to traditional teaching methods currently employed in STB courses in China.MethodsThis study was a parallel group, unmasked, randomised controlled trial. We included third-year medical students of a five-year training program from the Xiangya School of Medicine, Central South University who voluntarily participated in the trial. One hundred fifty-three medical students were randomized (1:1) into the PTEBL group (n = 77) or traditional group (n = 76). Every group was led by a single instructor. The instructor in the PTEBL group has experienced in educational reform. However, the instructor in the traditional group follows a traditional teaching mode. The teaching courses for both student groups had the same duration of four hours. Questionnaires were conducted to assess teaching quality before and after the course. The trial was registered in the Central South University (No. 2021JY188).ResultsIn the PTEBL group, students reported mastery in three fundamental STB skills—Direct Finger Compression (61/77, 79.2%), Packing (72/77, 93.8%), and Tourniquet Placement (71/77, 92.2%) respectively, while 76.3% (58/76), 89.5% (68/76), and 88.2% (67/76) of students in the traditional group (P > 0.05 for each pairwise comparison). 96.1% (74/77) of students in the PTEBL group felt prepared to help in an emergency, while 90.8% (69/76) of students in the traditional group (P > 0.05). 94.8% (73/77) of students reported improved teamwork skills after the PTEBL course, in contrast with 81.6% (62/76) of students in the traditional course (P = 0.011). Furthermore, a positive correlation was observed between improved clinical thinking skills and improved teamwork skills (R = 0.82, 95% CI: 0.74–0.88; P < 0.001).ConclusionsCompared with the traditional teaching method, the PTEBL method was superior in teaching teamwork skills, and has equally effectively taught hemostasis techniques in the emergency setting. The PTEBL method can be introduced to the STB training in China.

Advances in endoscopic management of colonic diverticular bleeding.

This review is focused on diagnostic and management strategies for colonic diverticular bleeding (CDB). It aims to present the current state of the field, highlighting the available techniques, and emphasizing findings that influence the choice of therapy. Recent guidelines recommend nonurgent colonoscopy (>24 h) for CDB. However, factors such as a shock index ≥1, which may warrant an urgent colonoscopy, remain under investigation.The standard approach to detecting the source of CDB requires a water-jet scope equipped with a cap. Innovative diagnostic techniques, such as the long-cap and tapered-cap, have proven effective in identifying stigmata of recent hemorrhage (SRH). Furthermore, the water or gel immersion methods may aid in managing massive hemorrhage by improving the visualization and stabilization of the bleeding site for subsequent intervention. Innovations in endoscopic hemostasis have significantly improved the management of CDB. New therapeutic methods such as endoscopic band ligation and direct clipping have substantially diminished the incidence of recurrent bleeding. Recent reports also have demonstrated the efficacy of cutting-edge techniques such as over-the-scope clips, which have significantly improved outcomes in complex cases that have historically necessitated surgical intervention. Currently available endoscopic diagnostic and hemostatic methods for CDB have evolved with improved outcomes. Further research is necessary to refine the criteria for urgent colonoscopy and to confirm the effectiveness of new endoscopic hemostasis techniques.

A novel endoscopic electrocoagulation hemostasis technique for uncontrolled intraprocedural bleeding: series connection of foreign body forceps and hemostatic forceps.

A novel endoscopic electrocoagulation hemostasis technique for uncontrolled intraprocedural bleeding: series connection of foreign body forceps and hemostatic forceps.

A Comparative Study between Lower Pole Silk Ligation and Pillar Suturing Technique of Hemostasis in Tonsillectomy

A Comparative Study between Lower Pole Silk Ligation and Pillar Suturing Technique of Hemostasis in Tonsillectomy

Step-Up Strategy for Endoscopic Hemostasis Using PuraStat After Endoscopic Sphincterotomy Bleeding (STOP Trial)

Background and AimsRecently, a novel self-assembling peptide hemostatic gel (PuraStat) has become available. Although PuraStat for endoscopic sphincterotomy (EST) bleeding has been evaluated and reported mainly in case reports and several retrospective studies, no prospective evaluation has been reported. The aim of the present study was to prospectively evaluate the safety and efficacy of PuraStat for persistent EST bleeding >120 seconds as a first-line endoscopic hemostasis technique. MethodsThis single-arm, prospective study was conducted between November 2022 and August 2023. As the primary technique for endoscopic hemostasis, PuraStat was applied first. If hemostasis failed, other techniques were used. The primary outcome of the present study was to evaluate the technical success rate of the application of PuraStat to the bleeding site. Clinical success was defined as the absence of oozing for 180 seconds after PuraStat application. Adverse events associated with procedures and secondary hemorrhage were secondary outcomes. PuraStat application was performed using the embankment method. ResultsDuring the study period, 1080 endoscopic retrograde cholangiopancreatography procedures were performed. A total of 108 patients experienced complications with EST bleeding. Among them, endoscopic hemostasis was required in 51 patients. These patients enrolled in this prospective study. All patients successfully underwent PuraStat application without PuraStat dislocation into the third part of the duodenum. The technical success rate of endoscopic hemostasis using PuraStat was 98% (50/51). As possible factors associated with secondary hemorrhage, biliary stents, including plastic or metal stents, were deployed in 60.7% (31/51). Finally, severe adverse events associated with the procedures were not observed in any patients, although mild acute pancreatitis was observed in 2 patients, and conservative treatment was successful. ConclusionIn conclusion, PuraStat application may be safe for oozing after EST without increasing the frequency of acute pancreatitis.

Новый метод гемостаза при тяжелых травматических повреждениях печени

Rationale: The search for new ways to stop bleeding in severe liver injuries is an urgent task of modern surgery, due to the technical complexity of known hemostasis methods, the high frequency of postoperative complications and the need for relaparotomies. Objective: To improve the results of treatment of patients with severe traumatic liver injuries. Methods: A randomized controlled clinical trial was conducted, including 70 patients with severe traumatic liver injuries. In the main group (n = 35), the original “Method of hemostasis in severe traumatic liver injuries” was used (patent Russian Federation 2792914). The control group (n = 35) uses traditional surgical techniques of hemostasis. Results: The groups were comparable in terms of the main demographic indicators, the degree of liver damage, and the combination of injuries. In the main group, complications were biliary — 31.4%, inflammatory, requiring relaparotomy — 5.7%, liver failure — 11.4%, there were no recurrence of bleeding, relaparotomy — 2 was performed. In the control group, complications were biliary — 40.0%, inflammatory, requiring relaparotomy — 28.6%, liver failure — 31.4%, recurrent bleeding — 8.6%, relaparotomy — 19. Conclusion: The original method of hemostasis allows to improve the results of treatment of patients with severe liver injuries, by reducing the frequency of postoperative complications and the need for relaparotomies. The effectiveness of the technique is based on the absence of direct contact of gauze tampons with the liver, which prevents them from sticking to the wound surface, impregnation with biological fluids and, accordingly, secondary infection.