Abstract
Revision total hip replacement is a procedure often associated with significant blood loss and subsequent transfusion. Intra-operative cell salvage is one approach to minimising this problem.
We carried out a retrospective study of 134 consecutive revision total hip carried out by one surgeon between June 2003 and September 2006 in the Southern General Hospital, Glasgow, 134 replacements (excluding those performed in the presence of active infection where cell salvage is contra-indicated).
In Group A (56 patients), operated upon after October 2005, Intra-operative cell salvage was routinely used. In Group B (78 patients), operated upon before October 2005, Intra-operative cell salvage was not used.
Data was collected on transfusion of salvaged blood, transfusion of allogenic blood, operation type, indication for surgery, complications and length of hospital stay.
In Group A, an average of 1.52 units of allogenic blood was transfused per case, compared with an average of 3.35 units in Group B (p=0.01), a reduction of 55%.
In Group A 50% of patients received allogenic blood transfusion, compared with 68% of patients in Group B, a relative reduction of 26% (0.1> p> 0.05).
There was no difference between the two groups regarding haemoglobin drop and length of hospital stay. Data regarding complications yielded no significant results due to small cohort size.
Further Breakdown of data by operation type and indication did not yield significant results due to the small cohort size.
Our results show that routine use of intra-operative cell salvage in revision total hip replacement leads to a significant reduction in allogenic blood transfusion with subsequent implications upon cost, resource management, and patient safety.
Correspondence should be addressed to Mr John Hodgkinson, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
