ABSTRACT
Local hemostasis is critical for successful surgical intervention and may be accomplished with a variety of techniques ranging from direct pressure to lasers. Critical assessment of the clinical situation is required to determine the appropriate technology necessary to achieve effective hemostasis. As a general rule, ligatures remain the mainstay for effecting hemostasis in all but the smallest isolated vessels. Although ligatures have been in use since the first century AD, both the applications as well as their sophistication have increased dramatically. As sutures are foreign material to the human body, tissue reaction is unavoidable. This response may be mitigated, but not eliminated completely, through the use of non-absorbable sutures. The body's inflammatory response triggers a complex cascade of cellular and biochemical events that lead to fibrinogenesis and coagulation. This process, in turn, results in an increased deposition of collagen that may result in formation of adhesions.
