[Possibilities and profits of blood saving in orthopedics and traumatology]

The author presents his own experiences related to blood saving methods in orthopedics and traumatology. The analysis was carried out on 56 patients who underwent major orthopedic procedures: 35 total hip arthroplasties, 19 total knee arthroplasties and two fusions of fractures of the spine performed between the end of 1998 and the beginning of 1999. Patients were prepared for elective surgery by carrying out autotransfusion, which gave on average 2 units of blood for each patients. During the post operative period blood for retransfusion was obtained through active drainage using CBC Consta VAC (Strayker) equipment and through active drainage using standard Baxter transfusion bags. This gave approx. 350-700 ml of blood after hip arthroplasties, 500-800 ml after knee arthroplasty and 500 ml after stabilization of spine fractures. An analysis of the morphotic values of blood from CBC (Strayker) and the transfusion bags (Baxter) did not reveal any statistically significant differences. This confirmed that both methods are equally useful for obtaining blood from the post-operative wound. However, the low cost and simplicity of downward drainage make this method more suitable for our hospitals. Autotransfusion yielded in our department an annual saving of 250 l of blood and in many planned operations eliminate the necessity for allogenic blood transfusion.