Abstract
Patients undergoing primary knee arthroplasty at our unit routinely have two units of red cell concentrate cross-matched preoperatively. We assessed whether postoperative blood salvage and auto-transfusion reduced the need for allogenic blood transfusion as compared with standard suction drainage.
Haemoglobin and haematocrit preoperatively and postoperatively were recorded. The amount of drainage and re-transfusion was noted as well as the amount of blood saved, used and wasted.
182 patients were audited. Patients were placed in one of two groups: Group A receiving auto-transfusion of blood salvaged postoperatively (128 patients); and Group B where suction wound drainage without salvage was utilized (54 patients). Pre- and postoperative haemoglobin and haematocrit estimations were similar in both groups. Total drainage averaged 1061mI (range 175–2230 ml) for group A and 760mI (range 100–2280 ml) for group B. Auto-transfusion volumes averaged 814ml (range 0–1700m1) in group A.
Allogenic blood transfusion was required in 23% of patients in group A in contrast to 50% in group B. This resulted in an average wastage of 1.6 units in group A as opposed to 1.1 units in group B.
Postoperative auto-transfusion of salvaged blood in patients undergoing primary total knee arthroplasty reduces the need for allogenic blood transfusion requirements. It would also serve to reduce the wastage in units of whole blood allowing such patients to be routinely “grouped and retained” rather than “crossmatched”.
The abstracts were prepared by Mr R. B. Smith. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.
