Abstract
Background
The incidence of scoliosis is 2/1000 population in the UK with 80% being idiopathic. In the Royal Victoria Hospital, Belfast there are approximately 25 scoliosis operations per year, the majority are for idiopathic causes and are limited to posterior instrumentation and fusion. It is current practice in this hospital to use a cell salvage machine for every case managed by nursing staff.
Objective
To ascertain the requirement for and the economical viability of cell salvage during posterior instrumented scoliosis surgery.
Method
Retrospective study looking at 35 charts of patients who had undergone scoliosis surgery (4 were excluded – 3 fracture patients and 1 patient aged 59). We looked at pre-operative haemoglobin, intra-operative blood loss and the need for post-operative transfusion
Results
Average age of patient 15.4 years; 28/31 causes were idiopathic; average blood loss 1282 mls (only 11 charts had it recorded); average pre-operative Hb 13.9; 7 patients required transfusion, 3 of which received cell salvaged blood only (average volume of cell salvaged blood was 148mls) and 2 out of 3 patients with neuromuscular disorders required blood transfusion. To make cell salvage economically viable it has been calculated that approximately 400 cases need to be performed– in our unit this would equate to 16 years assuming each patient yielded 1 unit of blood.
Conclusion
This study does not support the routine use of a Cell Saver in posterior instrumented fusion scoliosis surgery in the population group. However, in patient with underlying neuromuscular and congenital abnormalities it may be viable.
