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The need for grass roots innovation in developing countries: a case for stationery binder clips in scalp hemostasis
EANS Academy. Tripathi M. 09/25/19; 275430; EP12037
Manjul Tripathi
Manjul Tripathi

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Objective: The primary training in any surgical practice starts with tissue handling and effective hemostasis. Neurosurgical procedures start with an incision in scalp and it needs summative use of mechanical hemostats and bipolar coagulation to achieve hemostasis. Though the Raney clips are the most popular and effective in maintaining hemostasis yet their high cost and non reusability becomes a deterrent for routine use in resource stricken environments.
Material and methods: We have compared the stationary binder clips of different sizes with Raney clips on the parameters of effectiveness, availability and cost. Binder clips were also used in intraoperative settings for scalp hemostasis. The comparative efficacy, additional usage of cautery, and need for sterilization is also discussed.
Results: Authors here describe their experience with simple stationary metal binder clips in maintaining effective hemostasis in a cost effective manner. The 25 mm size binder clip exerts same force as Raney clip without any tissue injury. Practical application revealed effective scalp hemostasis up to blood pressure of 150 mm Hg.
Conclusion: Stationary binder clips are a cost effective, ready to use alternative for standard Raney clips.
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