HEMOSTASIS always presents a major problem to the surgeon. Where bleeding is brisk, as from a severed artery or large vein, it is usually stopped immediately by the application of forceps and ligatures. Much more difficult to control is the constant oozing that results from injury to small venules and capillaries. If one measures loss of blood by the increment of gain in dry sponges,1 it becomes readily apparent that most of the loss of blood during the usual major surgical procedure is from the latter, rather than from the former, source of bleeding.
Bleeding from brain, kidney, liver or vascular tumors is difficult to control by the application of forceps or clips because of the friability of the tissues. In an operative field where infection is present or has subsided (as in decortication of a lung), the bleeding from the friable and tough fibrous tissue is most difficult
STATE D. USE OF HUMAN FIBRIN FOAM AND THROMBIN SOLUTION AS HEMOSTATIC AGENTS IN GENERAL SURGERY. Arch Surg. 1949;58(3):284–290. doi:10.1001/archsurg.1949.01240030290005
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