Background: The aim of this study was to compare the incidence of POSTOPERATIVE secondary hemorrhage for tonsillectomy and submucosal uvulopalatopharyngoplasty (smUPPP).Materials and Methods: In this retrospective case series, the medical records of 404 patients who underwent tonsillectomy with unipolar electrocautery and smUPPP at our institution between January 2001 and December 2010 were reviewed. The patients were divided into two groups: Group 1 (198 patients) underwent tonsillectomy; Group 2 (206 patients) underwent smUPPP. Main outcome measures were incidence of BLEEDING or complications after tonsillectomy and smUPPP and the need for revision surgery.Results: The mean age of Group 1 patients was 38.1 (±2.58) years and that of Group 2 was 37.7 (±2.25) years. Males were 51.3% of Group 1 and 46.7% of Group 2. No statistically significant difference in age or gender distribution was found between Groups 1 and 2. The incidence of secondary, delayed hemorrhage was 5.05% (10 patients) in Group 1 and 1.45% (three patients) in Group 2 (P=0.05). The incidence of delayed hemorrhage requiring surgical treatment was 4.54% (nine patients) in Group 1 and 0.97% (two patients) in Group 2.Conclusion: In adults, smUPPP, which includes tonsillectomy, has a lower incidence of POSTOPERATIVE delayed hemorrhage than does tonsillectomy with unipolar cautery.

Background: BLEEDING time is the most reliable test to assess platelets' function. We initiated this study to determine the relationship between preoperative BLEEDING time and POSTOPERATIVE hemorrhage.Materials & Methods: 149 patients underwent elective coronary artery bypass grafting surgery with no history of BLEEDING disorders, from winter 1380 till the first six month of 1381, were enrolled in a prospective descriptive study. Preoperative BLEEDING time, POSTOPERATIVE blood loss from left, right and mediastinal chest tubes and total blood loss during and after operation, duration of extracorporeal blood circulation, grafts' number and infused packed red blood cells and platelets units were measured. Results: There was no significant relation between total blood loss from thoracic tube with operation time (r =0.03), extracorporeal blood circulation time (r =0.21), graft number (r=0.09) and infused packed red blood cells units (r=0.03) or infused platelet units (r =0.12) (P>0.05). But the relations between BLEEDING time (sec) and blood loss from left (r=52), right (r=0.81) and mediastinal (r=0.79) chest tube and total blood loss of thoracic tube (r =0.70) (P<0.05) were significant. Conclusion: BLEEDING time measurement is recommended to predict the POSTOPERATIVE BLEEDING.  

Background- CABG is the most common type of cardiac surgery which generally is done under cardiopulmonary bypass (CPB). Hypothermic CPB was introduced in cardiac surgery in order to protect organs against hypoperfusion. Hypothermia is associated with many adverse effects on the vital organs, which result in impairment of organ and systemic function.Normothermia on the other hand is more in agreement with the physiology of human organs. The aim of this study is to evaluate the effect of body temperature during CPB on POSTOPERATIVE BLEEDING.Methods- One hundred patients were randomized into normothermic (35-37° C, N=50) and mild hypothermic (28-32° C, N=50) CPB groups and compared with respect to blood loss, transfusion requirements and platelet level in primary coronary artery bypass grafting. The patients' hemoglobin levels, leukocyte counts and platelet counts were measured before operation, immediately upon arrival in the intensive care unit, 4 hours afterwards and 6 days after surgery. The volume of blood shed through mediastinal and pleural drainage tubes were recorded at 6, 12 and 24 hours after operation.Results-There were no differences in preoperative characteristic including patient age, sex, number of occluded vessels, weight, height, hemoglobin and hematocrit level, platelet and WBC levels. Normothermic patients tended to bleed less at 24 hours (warm, 288±30 ml than in hypothermic patients. The warm group had a reduced blood loss by 40 percent after 6, 34% after 12 and 30% after 24 hours as compared with blood loss in hypothermically-perfused patients.Conclusion-These data suggest that normothermic systemic perfusion reduced POSTOPERATIVE blood loss and preserved platelets.

Background: Open prostatectomy is still accompanied by some POSTOPERATIVE BLEEDING. Prescribing fibrinogen to promote clot formation in patients with BLEEDING is of critical importance. This research studied the effects of local injection of fibrinogen on level of POSTOPERATIVE BLEEDING in open prostatectomy. Methods: Overall, 44 patients were randomly entered in a study on open prostatectomy. Patients in the intervention group received local injections of 500 mg fibrinogen (20 mL) dissolved in distilled water, and the control group patients only received 20 mL of normal saline, where the injections were given by the surgeon at the prostatectomy operation site. All patients were tested for hemoglobin, hematocrit, PT, PTT, INR, and fibrinogen level. Also, the amount of blood loss and requirement for blood products were recorded. Results: The study groups showed no difference regarding baseline variables. One patient in the fibrinogen group (1. 66%) and four patients in the control group (6. 66%) received blood products (P < 0. 05), and the blood drainage tube at 24 hours after operation was 36. 50) 18. 70 (mL in the fibrinogen group and 151. 36) 120. 58 (mL in the control group (P = 0. 005). There were no differences in hemoglobin, hematocrit, PT, PTT, INR, and serum fibrinogen level between the groups at any time. Conclusions: The current study demonstrated that using fibrinogen in patients with high BLEEDING risk may effectively reduce the amount of BLEEDING and its subsequent blood transfusion requirement, after open prostatectomy surgery.

Background: Intraoperative BLEEDING is an unwanted and common complication in orthopedic surgeries, which can be aggravated by the preventive administration of anticoagulants to prevent deep vein thrombosis. The present study examines the effect of prophylactic enoxaparin to prevent thromboembolism on the amount of BLEEDING in femoral head surgeries where it is not possible to use a tourniquet. Methods: A prospective descriptive-analytical study was conducted from July to March 2017 in Kashani Hospital, Isfahan, in 120 patients without a history of coagulation disorders who were candidates for reconstructive surgery for femoral head and neck fractures. Inclusion criteria involved age over 18, BMI less than 30, no history of coagulation disorders, no preoperative use of anticoagulant drugs, normal PT, PTT, and INR before starting enoxaparin. The patients didn’t have any coagulation disorder and all of them were under prophylactic dose of enoxaparin before surgery. The patients were subjected to spinal anesthesia with the same method. Signs related to degree of BLEEDING recorded during surgery and recovery care.  Data were collected and entered into SPSS software version 20, and central tendency and dispersion indices were calculated for quantitative variables. Descriptive tables and charts were utilized for qualitative variables. Correlation coefficient and linear regression analyses were performed for the final interpretation of results. Results: There was a significant relationship between mean arterial pressure and intraoperative BLEEDING (p-value=0.001). The dose of enoxaparin prescribed was associated with the volume of fluids received, the amount of BLEEDING, the amount of tranexamic acid, phenylephrine, labetalol, TNG and fentanyl administered during the operation with a p-value of less than 0.05. Also, there is a significant relationship between the prescribed dose of enoxaparin and the duration of surgery and duration of recovery care (p-value less than 0.05). Conclusion: The study examines the impact of prophylactic enoxaparin on intraoperative BLEEDING, finding a significant correlation with dosage and duration. No notable difference in BLEEDING was observed in patients with a GFR below 30. Enoxaparin administration correlated with increased BLEEDING, MAP levels, fluid volume, tranexamic acid use, and hypotension medications during surgery.