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Dutch orthopedic blood management surveys 2002 and 2007: an increasing use of blood-saving measures

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Hip and knee arthroplasties are frequently complicated by the need for allogeneic blood transfusions. The surveys were developed to assess the use of blood-saving measures in orthopedic surgery in the Netherlands in 2002 and 2007.

Study design and methods

In 2002 and 2007, a questionnaire on blood management measures after several orthopedic procedures was sent to all Dutch orthopedic departments (110 and 96, respectively).

Results

The response was 79% in 2002 and 84% in 2007. The use of preoperative autologous blood donation remained virtually unchanged in 2002 versus 2007 for both hip (10.9 and 10.5%) and knee (5.7 and 8.2%) arthroplasty. In 2007, there was a substantial increase in departments using erythropoietine for hip (31.6–66.1%) as well as knee (24.0–55.5%) arthroplasty. There was an increase of the use of autologous retransfusion of intraoperatively suctioned washed blood in hip (20.3–28.4%) as well as knee arthroplasty (8.9–16.1%) over the 5-year period, but it was predominantly used in revision hip arthroplasty (54.3%). The use of postoperative autologous retransfusion of filtered drained wound blood increased dramatically in 5 years time in hip (11.5–51.0%) and knee arthroplasty (15.9–59.3%).

Conclusion

There is an evident increase in the preoperative use of erythropoietin and the postoperative use of autologous retransfusion of drained blood among Dutch orthopedic departments. There appears to be an increasing awareness and positive attitude among Dutch orthopedic surgeons to implement perioperative blood-saving measures.

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Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Kennemer Gasthuis Haarlem, Boerhaavelaan 22, 2035 RC, Haarlem, The Netherlands

    Wieger Geert Horstmann

  2. Department of Orthopedic Surgery and Traumatology, Isala Clinics, Zwolle, The Netherlands

    Harmen B. Ettema & Cees C. P. M. Verheyen

Authors
  1. Wieger Geert Horstmann
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  2. Harmen B. Ettema
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  3. Cees C. P. M. Verheyen
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Correspondence to Wieger Geert Horstmann.

Appendix

Appendix

Survey 2002: Bloodmanagement hip and knee prothesiology

Preventive blood-saving measures taken regularly in your orthopaedic department in order to reduce perioperative blood loss and allogenic blood transfusions following hip and knee arthroplasty.

Please, circle the appropriate answers: the surgical procedures in which you apply the stated perioperative measures

Preoperative autologous blood donation

THP/KHP/RevHP/TKP/hKP/RevKP

Erythropoietine (EPO)

THP/KHP/RevHP/TKP/hKP/RevKP

Intraoperative cellsalvage

THP/KHP/RevHP/TKP/hKP/RevKP

Postoperative autologous retransfusion drained blood

THP/KHP/RevHP/TKP/hKP/RevKP

Other measures, i.e.

THP/KHP/RevHP/TKP/hKP/RevKP

  1. THP total hip prosthesis, KHP Kophals prosthesis = hemi hip prosthesis, RevHP revision hip prosthesis, TKP total knee prosthesis, hKP hemi knee prosthesis, RevKP revision knee prosthesis

Survey 2007: Bloodmanagement hip and knee prothesiology

Preventive blood-saving measures taken regularly in your orthopaedic department in order to reduce perioperative blood loss and allogenic blood transfusions following hip and knee arthroplasty.

Please, circle the appropriate answers: the surgical procedures in which you apply the stated perioperative measures 

Preoperative autologous blood donation

THP/KHP/RevHP/TKP/hKP/RevKP

Erythropoietine (EPO)

THP/KHP/RevHP/TKP/hKP/RevKP

Intraoperative cellsalvage

THP/KHP/RevHP/TKP/hKP/RevKP

Platelet gel

THP/KHP/RevHP/TKP/hKP/RevKP

Fibrin sealant

THP/KHP/RevHP/TKP/hKP/RevKP

Postoperative autologous retransfusion drained blood

THP/KHP/RevHP/TKP/hKP/RevKP

Other measures, i.e.

THP/KHP/RevHP/TKP/hKP/RevKP

  1. THP total hip prosthesis, KHP Kophals prosthesis = hemi hip prosthesis, RevHP revision hip prosthesis, TKP total knee prosthesis, hKP hemi knee prosthesis, RevKP revision knee prosthesis

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Horstmann, W.G., Ettema, H.B. & Verheyen, C.C.P.M. Dutch orthopedic blood management surveys 2002 and 2007: an increasing use of blood-saving measures. Arch Orthop Trauma Surg 130, 55–59 (2010). https://doi.org/10.1007/s00402-009-0910-0

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