LA R.

MANALANG

CLOT RETRACTION
 CLOT RETRACTION

• In the past, this procedure has been used as a screening test for platelet function. With the
advent of more sophisticated tests for platelet function, however, this test is used
infrequently. Normal clot retraction requires a normal number of functioning platelets,
calcium, ATP and a normal fibrinogen level.
• SPECIMEN
• One of the tubes containing 1 mL of whole blood, used in the Lee and White clotting
time, or 3 mL of whole fresh blood, placed in a 13 x 100 mm glass test tube.
PRINCIPLE
• When will retraction occur
• It measures time needed for contraction of clot.  Indicate function and number of platelets.
 • This is due to the action of the platelets on the fibrin network.
• No anticoagulant for sample to clot
• Thrombosthenin – contractile protein responsible for clot retraction
• The contractile protein namely actin, myosin and thrombosthenin are
responsible for clot retraction.
• NOT A STAND ALONE TEST
• Increased in: Thrombocytopenia (decrease platelet)
• Normal values: 2-24 hours

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 HIRSHBOEK / CASTOR OIL
METHOD
• Clot retraction is the shrinking of a blood clot facilitated by thrombolytic agents.
• Clot retraction occurs due to the contraction, knotting, and twisting of the fibrin
mesh.
• “Dimpling phenomenon” or “nipple like protrusion”
• Observe for the formation of this protrusion on the surface of the drop of blood
in a clot retraction time
• This indicates the end point of Castor oil or Hirschboeck method
• Simplest method to perform

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 Materials
1. Test tube
2. Test tube rack
3. Sahli pipette
4. Syringe
5. Castor oil (5 – 10 mL)

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 PROCEDURE
1. Place about 5 mL of castor oil in a test tube.
2. Place the blood collected into a sahli pipette into the test tube.
3. Observe for the “dimpling phenomenon” of the blood to clot - 15 –
45 minutes
4. Report the result

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 MANNER OF REPORTING
• Presence of Dimpling Phenomenon
• Absence of Dimpling Phenomenon

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 STEFANINI – DAMESHEK
METHOD
• The process by which a blood clot becomes smaller and draws the
edges of a broken blood vessel together and which involves the
shortening of fibrin threads and the squeezing out of excess serum

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 MATERIALS
1. Test tube
2. Waterbath
3. Test tube rack
4. Syringe

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 PROCEDURE
1. 3 ml of blood is placed in a test tube and is incubated at 37 ⁰C
2. Clot retraction begins in one hour and is completed within 18-24
hours
3. Report the result

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 MANNER OF REPORTING
• Normal or complete retractility
• Partial retractility
• Poor retractility
• Very poor retractility

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 MACFARLANE METHOD
• This test measure the amount of time it takes for a blood clot to pull
away from the walls of a test tube.
• It is used to evaluate and manage blood platelet disorders, including
• Glanzmann’s thrombasthenia
• Aggregation (weak platelets)
• Lack GPIIb-IIIa

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 MATERIALS
1. Test tube
2. Coiled wire
3. Cork
4. Syringe
5. Alcohol pad
6. Gauze pad

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 PROCEDURE
1. A test tube with a capacity of 5 ml is filled with venous blood - Red top
2. A coiled wire is fused into the blood with the cork fitted at the neck of the tube
3. The tube is incubated at 37 ⁰C for 1 hour.
4. The tube is examined for coagulation at 5 to 10 minutes interval. The tube is
removed from the water bath after 1 hour. 5. If retraction has taken place, the
clot will be seen to have shrunken away from the wall of the tube and attached
only to the wire.
Normal values: 44 – 67%

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 FORMULA

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 SIGNIFICANCE OF CLOT RETRACTION
BLOOD TEST RESULT

• A high value for the Clot Retraction Blood Test may indicate:
• Thrombasthenia (weak plt)
• Bernard-Soulier syndrome (GPIb) (adhesion)
• The laboratory test results are NOT to be interpreted as results of a "stand-alone" test.
• The test results have to be interpreted after correlating with suitable clinical findings and
additional supplemental tests/information.
• The Clot Retraction Blood Test is not often performed in modern clinical practice. More
sophisticated and standardized methods are used instead
• Certain medications that you may be currently taking may influence the outcome of the test.
• Anticoagulant
• Aspirin
• Coumarin
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 CLINICAL INDICATIONS FFOR PERFORMING THE
CLOT RETRACTION BLOOD TEST

• Following are the clinical indications for performing the Clot Retraction Blood Test:
• Measuring coagulation ability, when more sophisticated methods are
unavailable
• Family history of blood clotting disorders
• Monitoring hemostatic therapy
• Excessive bleeding
• Bruising

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Thank you