​Compression and diathermia​

By Nikolaj Nerup, MD, PhD and Peter Olsen Svenningsen, MD 

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Manual compression is the least traumatic method of ensuring hemostasis and can be used to temporarily control bleeding until definitive surgical control is achieved. In large bleedings, packing of, for example, the abdomen may be indicated. In trauma-laparotomy for intraabdominal bleeding, the main focus is to provide control of the hemorrhage with packing. In laparoscopic surgery, gauze can be introduced with a grasper to compress the bleeding. 

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Diathermia is the use of electrical energy to heat tissue and can be used to both dissect and coagulate. It can be divided into monopolar and bipolar devices. Monopolar devices have only one electrode-generating electric current that passes near the tissue to another electrode typical placed around the leg of the patient (and should therefore not be used on patients with pacemakers!). In bipolar diathermia devices, both electrodes are mounted on the same device and electric current passes only through the tissue between them.