The control of severe intraoperative bleeding using an overlay autogenous tissue (OAT) patch: case reports.
BACKGROUND
Severe intraoperative bleeding cannot always be controlled by standard surgical techniques. We recently reported a new technique to repair serious vascular injury using a free graft of omentum or rectus abdominus fascia as an overlay autogenous tissue (OAT) patch in the experimental sheep model. We now describe the successful clinical use of this patch in three patients.


METHODS
Radical surgery was performed on three patients with pelvic malignancy with resulting uncontrollable bleeding from the internal iliac vein, pelvic side wall and paravaginal venous plexuses, respectively. Hemostasis was secured using an OAT patch made of abdominus rectus fascia in two cases and appendix epiploicae as an omental substitute in the other.


CONCLUSIONS
The utility of the OAT patch is described in three different clinical situations. It is suggested that this technique may be especially useful to gynecologic oncologists when standard surgical techniques fail to control bleeding or there is limited access to the site of injury.
Hammond
Ian G
IG
Western Australian Gynecologic Cancer Service, King Edward Memorial Hospital for Women, Subiaco, Perth 6008, Western Australia. hammond@wantree.com.au
Obermair
Andreas
A
Taylor
John D
JD
Lawrence-Brown
Michael
M
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000601:surgery*; D019737:Transplants; D014656:Vascular Surgical Procedures / Q000379:methods*