Pattie/cotton
- Slow bleeding/ooze from the cortex can be more effectively managed by using small pieces of wet cotton and the tamponade technique.
- Similarly, if a small perforator is inadvertently avulsed from its parent artery, coagulation is not used and a small piece of cotton tamponade will give natural haemostatic mechanisms an opportunity to plug the defect in the wall without placing the parent artery at risk.
Silver/Weck clips
- May be used for ligation of large vessels and dural veins (occipital or superior petrosal sinuses), but their application in microsurgery is very limited.
Ligature
- Less commonly used in neurosurgery than other specialties
Bone wax
- Made of
- Beeswax (70%)
- Vaseline (30%)
- Non-absorbable material
- Becoming soft and malleable in the hand when warmed.
- Uses
- Used to seal bleeding from the bone.
- This wax can be mixed with Gelfoam powder or Surgicel fibrillar to plug bleeding from the foramen spinosum.
- It may also used for obliteration of the air sinuses to avoid cerebrospinal fluid leaks.
- Sir Victor Horsely
- Cons
- Inhibits bone formation
Made with Bullet