There were 22 patients with cerebral palsy aged six to 17 years who underwent an acetabuloplasty as part of an open reduction of the hip. In 11 patients a paediatric cell saver was used to collect autologous blood which was re-infused per-operatively. This group was compared to a cohort of 11 patients undergoing similar operations in whom only banked homologous blood was transfused.

On average, 432 ml of autologous blood was re-infused compared to 909 ml of homologous blood (p < 0.01), representing 19.6% and 47% of the total blood volume, respectively (p < 0.002). Two units of homologous blood were transfused in the cell saver group compared with 20 units in the control group (p < 0.001). When using a paediatric cell saver, homologous blood transfusion was avoided in 82% of patients and there were no complications.

An intact barrier between the hands of the surgeon and the patient remains the single most important factor in protection against infection for both. Increasing the awareness of possible glove perforation without skin penetration will decrease the risk of contamination.

We performed a prospective, randomised trial comparing the incidence of glove perforation using a new type of glove (Regent Biogel Reveal) and standard double-gloves in total hip and knee replacement. One or more perforations was detected in 14.6% of all gloves. The new gloves increased significantly the awareness of perforation. Multiple perforations at the base of the ring finger were found in surgeons who wore wedding rings during the operation and we recommend that rings be removed before undertaking surgery.