Postoperative blood salvage in hip and knee arthroplasty. A prospective study on cost effectiveness in 161 patients.

We conducted a prospective controlled study on 161 patients who underwent primary or revision total hip or knee arthroplasty to assess the efficacy and limitations of postoperative blood salvage. The actual quantity of blood salvaged after washing, the theoretical increase in hemoglobin concentration caused by its reinfusion and the cost of this procedure were studied. The mean amount of packed red cells after washing was 117 g. The average increase in hemoglobin concentration, which theoretically would have been achieved by retransfusion, was 0.47 g/dL. One third of the devices used were discarded as not effective enough and, in order to obtain an increase of 1 g/dL in the hemoglobin concentration, an average of 3.4 postoperative Solcotrans Plus Orthopaedic devices were used. To obtain the same increase in hemoglobin concentration as that given by an allogeneic blood transfusion, the overall cost of materials alone was more than five times the price of a single blood unit transfusion.

[1]  D. Ayers,et al.  Blood salvage after total hip arthroplasty. , 1995, The Journal of bone and joint surgery. American volume.

[2]  J. J. Guerra,et al.  Cost effectiveness of intraoperative autotransfusion in total hip arthroplasty surgery. , 1995, Clinical orthopaedics and related research.

[3]  M. Kruskall,et al.  Red cell loss following orthopedic surgery: the case against postoperative blood salvage , 1994, Transfusion.

[4]  M. Levine,et al.  A randomized trial on the efficacy of an autologous blood drainage and transfusion device in patients undergoing elective knee arthroplasty , 1992, Transfusion.

[5]  P. W. Kristensen,et al.  Autotransfusion of drainage blood in arthroplasty. A prospective, controlled study of 31 operations. , 1992, Acta orthopaedica Scandinavica.

[6]  T. Sculco,et al.  Salvage and reinfusion of postoperative sanguineous wound drainage. A preliminary report. , 1992, The Journal of bone and joint surgery. American volume.

[7]  R. Volz,et al.  Postoperative blood salvage in total hip and knee arthroplasty. A randomised controlled trial. , 1991, The Journal of bone and joint surgery. British volume.

[8]  R. H. Turner,et al.  Blood conservation in major orthopedic surgery. , 1990, Clinical orthopaedics and related research.

[9]  G. Brittenham,et al.  Red blood cell mass in autologous and homologous blood units , 1989, Transfusion.

[10]  D. Schurman,et al.  Postoperative blood salvage using the Cell Saver after total joint arthroplasty. , 1989, The Journal of bone and joint surgery. American volume.

[11]  W. Wilson.  Intraoperative autologous transfusion in revision total hip arthroplasty. , 1989, The Journal of bone and joint surgery. American volume.

[12]  S. Woolson,et al.  Transfusion of previously deposited autologous blood for patients undergoing hip-replacement surgery. , 1987, The Journal of bone and joint surgery. American volume.

[13]  J. Callaghan,et al.  Prior deposition of autologous blood in elective orthopaedic surgery. , 1987, The Journal of bone and joint surgery. American volume.