Abstract
Aim of the study
To determine if the intraoperative use of cell salvage (CS) led to a decrease in allogeneic blood transfusion by comparing with a control group that did not receive CS. We also looked at the effects of injury severity and surgical approach.
Methods
This was a retrospective study at a major trauma center. One hundred and nineteen patients underwent open reduction and internal fixation of pelvic and acetabular fractures with (59 patients) or without intra-operative blood cell salvage (60 patients). The main outcome measurements were allogeneic blood transfusion during and after surgery with respect to CS, injury severity and surgical approach.
Results
We did not find any significant difference in the allogeneic blood transfusion between the CS and non-CS groups (rate—62% vs. 48%, p value 0.12 {significant at < 0.05}, volume 5.56 units vs. 5.58 units, p value 0.33). The rate (71.1% vs. 48.9%, p = 0.02) and volume (7.6 units vs. 4.3 units, p value 0.00057) of post-operative blood transfusion was significantly higher in the more severely injured (ISS > 20), but there was no significant difference between the CS and non-CS groups. No significant difference was seen between either patients who had anterior or posterior surgical approaches.
Conclusions
We did not find CS clearly efficacious clinically or cost effective, even in the more severely injured patients or when different surgical approaches were used. We do not advocate the routine use of CS in pelvic and acetabular surgery, but selectively, based on surgeon and patient preference.
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Acknowledgements
We would like to thank Dr. Abdul-Rahman Gomaa for his help with the statistical analyses. We would like to thank Mr. Ahmed El-Bakoury for his advice about the study design.
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Informed consent has been obtained from the patients of this study.
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Jawed, A., Ahmed, A. & Williams, M.R. Intra-operative cell salvage in pelvic and acetabular fracture surgery: a retrospective comparative study. International Orthopaedics (SICOT) 43, 1695–1699 (2019). https://doi.org/10.1007/s00264-018-4104-7
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DOI: https://doi.org/10.1007/s00264-018-4104-7