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David V. Pecora, M.D.
Principal Thoracic Surgeon Ray Brook State Tuberculosis Hospital Ray Brook, N.Y.

AMA Arch Surg. 1962;84(5):598.

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To the Editor.

—During the past 20 years, both the availability and use of blood for replacement have increased tremendously. Indeed, the copious supply of blood has to a certain extent transformed the character of surgery to a degree in which meticulous hemostasis is not infrequently considered a time-consuming luxury. Such a philosophy might be tenable if failure to achieve adequate hemostasis did not interfere with proper wound healing, and if it did not, by increasing the need for blood replacement, increase the number of transfusion complications. It is encouraging to detect evidence that the need for meticulous hemostasis is being reemphasized. Boone and Shumacker (J. Thor. Cardiov. Surg. 41:680, 1961) demonstrated that with careful hemostasis, blood replacement is rarely necessary after closed cardiovascular surgery, excluding procedures upon the thoracic and abdominal aorta. They determined blood loss by weighing sponges and measuring the volume in the suction apparatus.

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