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.