Jonathan Manara1, Harvey Sandhu2, Michael Wee3, Adekoyejo Odutola4, Thomas Wainwright5,6, Charles Knowles7, Robert Middleton5,8. 1. Southmead Hospital, North Bristol NHS Trust, Bristol, BS10 5NB, UK. jonathanmanara@doctors.org.uk. 2. Royal United Hospital, Combe Park, Bath, BA1 3NG, UK. 3. Poole Hospital NHS Foundation Trust, Bournemouth University, Poole, BH15 2JB, UK. 4. Weston General Hospital, Grange Rd, Weston-super-Mare, BS23 4TQ, UK. 5. Orthopaedic Research Institute, Bournemouth University, 6th Floor, Executive Business Centre, 89 Holdenhurst Road, Bournemouth, BH8 8EB, UK. 6. Physiotherapy Department, The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Castle Lane East, Bournemouth, BH7 7DW, UK. 7. Barts and The London School of Medicine and Dentistry, 1st Floor, Abernethy Building, 2 Newark Street, London, E1 2AT, UK. 8. Orthopaedic Department, The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Castle Lane East, Bournemouth, BH7 7DW, UK.
Abstract
INTRODUCTION: Revision hip surgery is well documented to have a high association with substantial blood loss and the associated need for a blood transfusion. This exposes the patient to increased risk of transfusion reaction and blood borne infection. There are many strategies to minimize allogeneic transfusion rates in revision surgery such as pre-operative autologous donation, peri-operative tranexamic acid, thrombin sealants, normovolaemic haemodilution, intra-operative blood salvage and the use of post-operative autologous drains. PATIENTS AND METHODS: We prospectively looked at 177 consecutive cases performed at one centre by a single surgical and anaesthetic team to identify which patient and operative factors were most significant in minimizing the requirement for an allogeneic blood transfusion. RESULTS: Our results identified the duration of surgery as being the only significant variable affecting the level of blood loss. We noted a 3% increase in the probability of massive blood loss (> 2000 mls) for every minute of increased surgical time in our series. CONCLUSIONS: We conclude that measures to minimize the duration of surgery would be beneficial in reducing blood loss and the risks of requiring blood transfusions in revision hip surgery.
INTRODUCTION: Revision hip surgery is well documented to have a high association with substantial blood loss and the associated need for a blood transfusion. This exposes the patient to increased risk of transfusion reaction and blood borne infection. There are many strategies to minimize allogeneic transfusion rates in revision surgery such as pre-operative autologous donation, peri-operative tranexamic acid, thrombin sealants, normovolaemic haemodilution, intra-operative blood salvage and the use of post-operative autologous drains. PATIENTS AND METHODS: We prospectively looked at 177 consecutive cases performed at one centre by a single surgical and anaesthetic team to identify which patient and operative factors were most significant in minimizing the requirement for an allogeneic blood transfusion. RESULTS: Our results identified the duration of surgery as being the only significant variable affecting the level of blood loss. We noted a 3% increase in the probability of massive blood loss (> 2000 mls) for every minute of increased surgical time in our series. CONCLUSIONS: We conclude that measures to minimize the duration of surgery would be beneficial in reducing blood loss and the risks of requiring blood transfusions in revision hip surgery.
Authors: A C Kaya; M P Radosa; J S M Zimmermann; L Stotz; S Findeklee; A Hamza; P Sklavounos; F Z Takacs; G Wagenpfeil; C G Radosa; E F Solomayer; J C Radosa Journal: Arch Gynecol Obstet Date: 2021-08-21 Impact factor: 2.344