Hemostasis or
haemostasis (
hemo- +
-stasis) is a process which causes bleeding to stop, meaning to keep blood within a damaged blood vessel (the opposite of hemostasis is
hemorrhage). It is the first stage of
wound healing. This involves
coagulation, blood changing from a liquid to a gel. Intact blood vessels are central to moderating blood's tendency to form
clots. The
endothelial cells of intact vessels prevent blood clotting with a heparin-like molecule and
thrombomodulin and prevent platelet aggregation with
nitric oxide and
prostacyclin. When endothelial injury occurs, the endothelial cells stop secretion of coagulation and aggregation inhibitors and instead secrete
von Willebrand factor which initiate the maintenance of hemostasis after injury. Hemostasis has three major steps: 1) vasoconstriction, 2) temporary blockage of a break by a platelet plug, and 3) blood coagulation, or formation of a fibrin clot. These processes seal the hole until tissues are repaired.