Technique
We describe a tamponade procedure for the control of post-Caesarean
hysterectomy bleeding. Dependent on the use of a surgical glove and a
sphygmomanometer, the technique was effective to control pelvic bleeding
in three patients who failed to respond to other interventions. The
method is easy to perform, low-cost, particularly suitable for the
low-resourced settings.
Summary: The technique is demonstrated in (Fig. 1, 2 and
a brief video). It employs two sterile catheters which are attached to a
surgical latex glove; one catheter is connected to a manual air-pump and
the other is connected to a sphygmomanometer. The glove is inflated and
positioned centrally into the pelvic cavity. The abdominal wall is
closed while the stem of the two catheters, the glove ligature, and an
intra-abdominal drain are passed through the skin incision. A wound
dressing together with an abdominal binder are then applied. The
intra-balloon pressure monitored by the sphygmomanometer. Initial
deflation should be attempted after 24 hours while observing the amount
of blood in the drain. The tamponade is deflated and removed, after
ensuring complete hemostasis, at bedside without the need for
anesthesia.