Clot Retraction
will aid in vascular wall and tissue repair.
Clot retraction or Clot retraction time
 Determines the length of time required for firm
clot formation by both platelets and fibrinogen.
Clot retraction measures the ability of the blood
to retract, which means that it decreases clot
size during formation of a hemostatic plug.
 When blood is allowed to be placed in a glass
tube without an anticoagulant at 37 degrees
celsius the clot will begin to shrink and "retract"
from the walls of the tube thus expressing the
serum.
 Clot retraction measures the percent of serum
yielded in the tube.
 Thrombosthenin, released by the platelets, is
responsible for clot retraction as well as other
contractile proteins- actin and myosin, because
of this we can use this test to determine both
platelet quantity as well as its function. Clot
retraction is directly proportional to the
platelet and inversely proportional to the
fibrinogen concentration.
 Normally clot retraction begins within 30
seconds after the blood has clotted.
 At the end on 1 hour: There should be
appreciable clot retraction
 At the end of 4 hours: Almost complete
retraction
 Within 24 hours: Clot retraction must be
completed
NOTE:
 Measure how platelet work hand and hand in
certain factor and help to maintain and fixing
the damage tissue in our body
 Help diagnose what is the platelet quantities or
quality and platelet function
 Gross example if the platelet is enough of
number
Clot Retraction is influenced by:
1) The number and activity of platelets
 Platelets are the force-generating components
of clot-retraction. Once the hemostatic plug has
been formed the actin and myosin portion of
the platelets act together with fibrin to shrink
the size of the plug thus causing retraction that
2) Concentration of fibrinogen
 Fibrinogen is needed for fibrin formation that
will later on trap platelets and act together with
them to retract the clot and restore the
damaged blood vessel walls
3) Packed Cell Volume
 High red cell counts limit the degree of
retraction because of the large volume of red
cells within the clot.
Standard Procedure for Clot Retraction
Procedure:
1) Withdraw 3 ml of venous blood.
2) Place 1 ml of blood into each of 3 glass test
tubes /centrifuge tube and immediately
incubate in a 37ºC water bath. Set a timer for 1
hour.
3) At 1 hour, observe the clot and record results.
4) Inspect the tubes at 2, 4, and 24 hours, observe
and record results.
5) Examine the tubes for retraction after
incubation.
6) Separation of the clot from the test tube is
complete retraction (+4).
7) If clot retraction occurred within 2-4 hours:
NORMAL; between 4-24 hours: POOR.
Determination of Result: Approximate amount of
shrinkage in the clot. Either using percentage or using
the grading system.
Sources of Error When Performing Clot Retraction
 Shaking or jarring of the tube of blood should
be avoided. This may lead to a shortened clot
retraction time.
 Certain anemic patients with a low hematocrit
value show increased clot retraction due to the
formation of a small clot.
Interpretation of Results
The clot will retract from the walls of the tube until the
red cell mass occupies 50% of the total volume of blood
in the tube. There is a variable degree of retraction or
there is no retraction at all. Grades as follows:
  : no serum extruded
 1+ : 5-10% serum extruded
 2+ : 10-20% serum extruded
 3+ : 20-35% serum extruded
 4+ : 35-50% serum extruded
Results are reported as the length of time it took for the
clot to retract
 2-4 hrs is reported as normal
 After 4 hrs is reported as poor
 After 24 hrs is reported as no retraction
d) Incubate at 37 degrees celsius in a water bath
e) Examine every 5-10 minutes for retraction
f) After coagulation, leave the tube at room
temperature for retraction
g) After retraction has taken place, remove the
glass rod to remove the clot
h) measure the amount of serum left on the tube
directly against the calibration of the tube
Computation: %CR= ml of serum/ml of blood x 100
Normal Value 44-67%

Other Method's for Clot Retraction Time 4)Tocantin's Method

1) Hirschboeck Method 5) Budtz-Olsen Method

Makes use of Castor Oil Conditions that affect Clot Retraction Time

Procedure: Clot retraction becomes abnormal in the following

conditions:
a) Add one drop of Castor oil
b) Add one drop of blood
c) Start the timer & observe dimpling
Normal Values: 15-45 mins.
 < 15 minutes: Thrombotic Tendency
 >45 Minutes: Hemorrhagic Tendency
 Incomplete or Delayed occur in
Thrombocytopenia and Glanzmann
Thrombasthenia
 Fibrinogen deficiency (congenital or acquired)
 Thrombocytopenia (less than 100,000)
 Thrombosthenia
 Polycythaemia vera
 Reduced clot formation: Glanzmann
thrombasthenia , DIC, hypofibrinogenemia,
dysfibrinogenemia (small clot with increased
red blood cell “fall-out”)

2) Stefanini-Dameshek Method

Makes use of a single test tube

Procedure:

a) Withdraw 3ml of blood

b) Transfer in a Wasserman Tube
c) Incubate at 37 degrees celsius or place at room
temperature and allow 2 hours to elapse
d) After 2 hours observe the clot
e) Record observation as : No retraction, Partial
Retraction, or Complete Retraction
f) Observe the appearance of the clot. Record as
firm or soft

3) Macfarlane Method

Procedure:

a) Place 5ml of fresh blood in a calibrated tube

b) Place a glass rod into the tube
c) Fit a cork at one end of the glass rod