Abstract
Purpose of the study: To investigate whether autologous blood transfusion (ABT) drains and peri-operative cell salvage reduce allogeneic transfusion requirements for scoliosis surgery in our unit.
Methods: Prospective data collection on transfusion requirements of patients undergoing scoliosis surgery between January 2006 and February 2008. Cases were split into three groups, representing recent stepwise changes in transfusion practice. Group A received ‘traditional treatment’ of allogeneic red cell transfusion (ARCT) in response to intra- or post-operative anaemia (Hb< 8g/dL or symptomatic anaemia). Group B received peri-operative cell salvage in addition to ‘traditional treatment’. In group C, ABT wound drains were used alongside peri-operative cell salvage and ‘traditional treatment’.
Results: ARCT was required for 23 of the 35 procedures (66%) in group A, 22 of 37 (59%) in group B and 10 of 20 (50%) in group C. Where patients required ARCT, those in group C received fewer units (mean 2.6) than group B (mean 3.1) and group A (mean 3.7). There was no difference in mean preoperative haemoglobin levels (A – 13.56g/dL SD 1.36; B – 13.35g/dL SD 1.46; C – 13.94g/dL SD 1.25). Mean length of inpatient stay was lowest in group C (9.11 days), and lower in group B (12.02) than group A (13.75).
Conclusion: Use of ABT drains and peri-operative cell salvage lead to reduced allogeneic transfusion needs for scoliosis surgery in our unit. Lowest transfusion rates were seen when both were used together, leading to a 16% reduction in the need for ARCT.
Ethics approval: None
Interest Statement: None
Correspondence should be addressed to BSS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
