Postoperative blood salvage and reinfusion after total joint arthroplasty

Han, Chang-Dong; Shin, Dong-Eun

doi:10.1016/s0883-5403(97)90173-x

Cited by 66 publications

(47 citation statements)

References 13 publications

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“…Increased infection rates due to non-drained hematoma providing excellent culture medium [1,2] or drains acting as a conduit into the depth of the wound [3][4][5] as well as persistent oozing from the surgical incision or out of the drainage hole [1,6] are potential disadvantages of both, using or omitting drains. Additionally, using drains might increase needs for homologous blood transfusions or reduce them by postoperative re-transfusion of drained blood [7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Closed suction drainage with or without re-transfusion of filtered shed blood does not offer advantages in primary non-cemented total hip replacement using a direct anterior approach

Kleinert

Werner

Mamisch-Saupe

et al. 2011

Arch Orthop Trauma Surg

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Introduction Wondering if the use of drains allowing retransfusion of shed blood as opposed to closed suction drains or no drains would improve quality of care to patients undergoing simple non-cemented primary total hip replacement (THR) using a direct anterior approach, a three-arm prospective randomized study was conducted. Method One hundred and twenty patients were prospectively randomized to receive no drain, closed suction drains or drains designed for re-transfusion of shed blood. Blood loss, VAS pain scores, thigh swelling, hematoma formation, number of dressings changed and hospital stay were compared and patients followed for 3 months. Results Drains did not have any significance on postoperative haemoglobin and haematocrit levels or homologous blood transfusion rates. Patients receiving homologous blood transfusions had too small drain volumes to benefit from re-transfusion and patients, who get drained fluid re-transfused, were far away from being in need of homologous blood transfusion. Omitting drains resulted in more thigh swelling accompanied with a tendency of slightly more pain during the first postoperative day but without effect on clinical and radiological outcome at 3 months. Earlier dry operation sites resulting in simplified wound care and shorter hospital stay was encountered when no drain was used. Conclusion The possibility to re-transfuse drained blood was not an argument for using drains and, accepting more thigh swelling, we stop to use drains in simple noncemented primary THR using the direct anterior approach.

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Section: Introductionmentioning

confidence: 99%

Closed suction drainage with or without re-transfusion of filtered shed blood does not offer advantages in primary non-cemented total hip replacement using a direct anterior approach

Kleinert

Werner

Mamisch-Saupe

et al. 2011

Arch Orthop Trauma Surg

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“…transfusions include autologous blood transfusion [10,34,37], postoperative blood salvage [1,9,16,20,21,34,52], use of a femoral intramedullary plug [43], hypotensive anesthesia [30], cryotherapy and Jones bandage [18], use of fibrin tissue adhesive [33,58], drain clamping [41,42,45,46,48,51,54,59], and administration of tranexamic acid [6-8, 19, 23, 24, 27, 28, 35, 39, 53, 55].…”

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confidence: 99%

Tranexamic Acid Reduces Blood Loss and Blood Transfusion after TKA: A Prospective Randomized Controlled Trial

Charoencholvanich

Siriwattanasakul

2011

Clinical Orthopaedics &Amp; Related Research

138

105

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Background TKA may be associated with considerable blood loss, and transfusion carries substantial risk of immunologic reaction and disease transmission. Blood transfusion also involves additional cost, therefore a reduction in its use is important. Several methods reportedly reduce postoperative blood loss and avoid homologous blood transfusion with traditional TKA approaches, but it is unclear these reductions apply to a minimally invasive technique. Questions/purposes We asked whether tranexamic acid administration could reduce blood loss and blood transfusion requirements after TKA.

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“…Because it is easy, effective, safe enough, and applicable in every patient, nowadays, postoperative salvage of blood from wound drainage is preferred in TKA [7,8,11,13,23]. Since most of the bleeding occurs not during, but early after the operation, postoperative autotransfusion decreases the p=differences in number of pixels in each group in preoperative and postoperative period.…”

Section: Discussionmentioning

confidence: 99%

Effect of shed blood retransfusion on pulmonary perfusion after total knee arthroplasty: a prospective controlled study

Altınel

Kaya

Köse

et al. 2006

International Orthopaedics (SICO

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Postoperative shed blood retransfusion (autotransfusion) is a commonly used salvage method following major surgical operations, such as total knee arthroplasty (TKA). The systemic effects of shed blood are still unclear. We studied the effect of residual substances in the retransfused shed blood, on lung perfusion after TKA. Fifteen unilateral and one bilateral TKAs were performed with autotransfusion (the study group) and 15 unilateral and three bilateral TKAs were performed in a control group. Lung Xrays, arterial blood gases (ABG), D-dimer values, and lung perfusion scintigraphies were performed preoperatively and postoperatively. A mean of 300.0±335.6 ml of bank blood was needed in the autotransfusion group and a mean of 685.7±365.5 ml of bank blood was needed in the control group (p=0.001). There was a postoperative segmental perfusion defect at the lateral segment of the superior lobe of the left lung in one patient of the control group and he also had risk factors for thrombosis. Although both groups had a decrease in lung perfusion postoperatively, there were no significant differences among the groups regarding the lung perfusion scintigraphy, chest X-rays, ABG, and Ddimer values. In conclusion, although pulmonary perfusion diminishes following TKA, shed blood retransfusion does not add any risk to pulmonary perfusion. Résumé La retransfusion post-opératoire est souvent utilisée dans les interventions majeures comme les prothèses de genou. L'effet systémique du sang récupéré n'est pas très connu. Nous avons étudié les effets de cette transfusion sur la perfusion pulmonaire. 15 prothèses de genou unilatérales et une bilatérale étaient réalisées en autotransfusion avec un groupe de contrôle de 15 unilatérales et 3 bilatérales. Des radiographies pulmonaires, les gaz du sang, la valeur des Ddimer et des scintigraphies de la perfusion pulmonaire étaient faites avant et après l'opération. Une moyenne de 300,0+−335,6 ml de sang de banque était nécessaire dans le groupe autotransfusion et une moyenne de 685,7+−365,5 ml était nécessaire dans le groupe de contrôle (p=0,001). Il y avait un déficit segmentaire de perfusion chez un patient du groupe de contrôle et il avait aussi des facteurs de risque thrombotique. Bien que les 2 groupes avaient une diminution de la perfusion pulmonaire, il n'y avait pas de différ-ences entre les 2 groupes pour la scintigraphie pulmonaire, les radiographies, les gaz du sang et les valeurs des D-dimer. En conclusion, bien que la perfusion pulmonaire diminue à la suite de l'arthroplastie totale de genou, la retransfusion du sang répandu n'entraine pas de risque particulier.

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Postoperative blood salvage and reinfusion after total joint arthroplasty

Cited by 66 publications

References 13 publications

Closed suction drainage with or without re-transfusion of filtered shed blood does not offer advantages in primary non-cemented total hip replacement using a direct anterior approach

Closed suction drainage with or without re-transfusion of filtered shed blood does not offer advantages in primary non-cemented total hip replacement using a direct anterior approach

Tranexamic Acid Reduces Blood Loss and Blood Transfusion after TKA: A Prospective Randomized Controlled Trial

Effect of shed blood retransfusion on pulmonary perfusion after total knee arthroplasty: a prospective controlled study

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