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 My question is this: Is this test considered outdated?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 Yes, the bleeding time is obsolete and should be discontinued, it cannot predict surgical bleeding and has limited efficacy in screening for platelet disorders.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
We are talking about the same. I’ve seen this test only once
We are talking about the same. I’ve seen this test only once. When my lab get devices I hope I can comment.
In my country Surgicutt is very expensive.
From Geo: it may not be worth the expense, as the bleeding time has little predictive value.
Hello. I know the Borgchevnick method for platelet adhesion
Hello. I know the Borgchevnick method for platelet adhesion in vivo using these devices.What is your opinion of this?
From George: My spelling is a little different, I have it as the Borchgrevnick in vivo platelet adhesion test, with references from the 1960s. In this test, the operator makes a capillary incision, collects blood immediately, then another sample after a specified time period, and compares the two platelet counts as a measure of platelet adhesion to the wound. I’ve never seen it used or attempted it. It seems the whole blood platelet count would remain relatively constant despite the number of platelets that adhere within the wound, but I would like to hear from those who use the test.
We found that when we replaced our bleeding time with the Pl
We found that when we replaced our bleeding time with the Platelet Function Assay (Dade PFA-100) we had very little push back from our physicians.