Original memoirs: the control of bleeding in operations for brain tumors: with the description of silver 'clips' for the occlusion of vessels inaccessible to the ligature. 1911.

摘要

One of the chief objects of concern in intracranial surgery should be the avoidance of any unnecessary loss of blood, for at best, in many cases of brain tumor associated with venous stasis, bleeding is likely to be so excessive as to necessitate postponement of the final steps of the procedure until a second or even a third session. The common methods of blood stilling by sponge, clamp, and ligature are largely inapplicable to intracranial surgery, particularly in the presence of bleeding from the nervous tissues themselves, and any device which serves as an aid to hemostasis in these difficult operations will bring a number of them to a safe termination at a single sitting, with less loss of blood and less damage to the brain itself. In addition to the more familiar tourniquet for the scalp, and wax for diploetic and emissary bleeding, suggestions are offered as to the use of gauze pledgets, dry sterile cotton, fragments of raw muscle and other tissues, as well as sections of organizing blood-clots for superficial meningeal bleeding, and silver "clips" for inaccessible individual points ether in dura or brain. The successful consummation of any critical operation often depends upon seeming trifles. It is, however, the scrupulous observance of surgical minutiae that makes possible the safe conduct of major intracranial performances--performances which a few years ago were attended in most cases by a veritable dance Macaber.