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단속적 원형봉합(Interrupted Circular Suture) 전치 유착태반 제왕절개 수술시 지혈방법

Interrupted Circular Suture: Bleeding Control During Cesarean Delivery in Placenta Previa Accreta

대한산부인과학회지 1994년 37권 12호 p.2343 ~ 2350
조주연
차광렬/계정웅/김수연/차경섭

Abstract


Raid accumulation of blood from the placental separation site during cesarean delivery for placenta previa sometimes obscures the surgical field and quickly leads to deterioration of the patient's vital signs. We used the following technique in
20
cases
of intractable bleeding among 120 cesareans for placenta previa.
Following failure to control the bleeding by suture at the placental separation site via the lower segment cesarean incision, the vessels were ligated using interrupted 2~3 cm sutures at 1cm intervals in a circle around the bleeding area on the
serosal
surface of the uterus.
The sutures were placed as deeply as possible in order to reach the endometrium. This led to marked decrease in bleeding and allowed the small vessels to be easily identified and ligated.
@ES The results were as follows.
@EN 1. The amount of blood transfused and the operation time were gradually reduced as we became adept in the use of this ptocedure.
2. Our experience suggests that this technique could reduce the use of hysterectomy in cesarean section for placenta previa.

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