From “slacey:” I work as a phlebotomist and and occasionally have to perform a bleeding time test. This involves making a small incision, using a Surgicutt device, and recording the time it takes for the
bleeding to stop. A blotting paper is used to determine when a platelet plug has formed and bleeding has stopped. My question is this: Is this test considered outdated? I would like to see this practice stopped as it is very subjective and leaves the patient with a small scar. Thank you for your feedback.
Hello, and thank you for your question. Yes, the bleeding time is obsolete and should be discontinued, it cannot predict surgical bleeding and has limited efficacy in screening for platelet disorders. Phlebotomy and laboratory personnel have trouble convincing surgeons to stop ordering the test, but they are more comfortable with the decision when they can read clinical proof. Here are four articles you can get from your medical library, they are a sampling of peer-review articles from the 1990s that prove the bleeding time has no value:
Houry S, Georgeac C, Hay JM, et al. A prospective multicenter evaluation of preoperative hemostatic screening tests. Am J Surg 1995;170:19-23.
Gewirtz AS, Miller ML, Keys TF. The clinical usefulness of the preoperative bleeding time. Arch Pathol Lab Med 1996;120: 353-356.
Lind SE. The bleeding time does not predict surgical bleeding. Blood 1991;77:2547-2552.
Rodgers RPC, Levin J. A critical reappraisal of the bleeding time. Semin Thrombos Haemostas 1990;16:1-19.
I hope this helps, there really is no rationale for performing bleeding times. Geo