Value of the autotransfusion of blood recovered from the post-operative wound in arthroplasty patients.

BACKGROUND: The authors present their experiences with autotransfusion of blood recovered from the post-operative wound in 178 patients after a hip or knee arthroplasty operated on in 2006 and 2007.

MATERIAL AND METHODS: We operated on 93 women and 63 men who underwent 33 emergency and 123 elective hip arthroplasties and 22 women who underwent elective knee arthroplasty. We used Unomedical's HandyVac ATS apparatus to recover and then auto-transfuse blood from the post-operative wound. Hemoglobin and hematocrit levels were determined in all patients before surgery and at 6 and 12 hours post-operatively.

RESULTS: For the entire group of 178 patients, we recovered 64,600 ml of blood by draining the post-operative wound. Of these, 112 (62.9%) patients did not require additional transfusions of allogeneic blood. Of the 123 patients who underwent elective hip arthroplasty, 28 women and 4 men required additional transfusions of allogeneic blood products. Of the 33 patients who underwent emergency surgery, 19 women and 6 men received allogeneic transfusions. Of the 22 female patients with gonarthrosis, 9 required allogeneic transfusion. The mean decrease in hemoglobin following the operation and autotransfusion of blood recovered from the post-operative wound was 2.76 g% in women and 2.91 g% in men after elective hip arthroplasty, and 2.15 g% after knee arthroplasty. In patients following emergency surgery, hemoglobin levels decreased by a mean of 3.2 g% in women and 3.1 g% in men.

CONCLUSIONS: Autotransfusion of blood recovered from the post-operative wound in patients after arthroplasty makes it possible to avoid transfusion of allogeneic blood products and reduces the postoperative decrease in hemoglobin levels.