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Barriers and facilitators to cell saver use in damage control surgery
B P Satter1,2, Robert A van der Horst1,2, Tim W H Rijnhout1,2
1Department of Surgery, Alrijne Medical Center, Leiderdorp, The Netherlands.
Transfusion
|May 18, 2026
Summary
Cell savers (CS) are useful in damage control surgery (DCS), but barriers like time and training exist. Addressing these could improve autologous blood use during shortages.
Area of Science:
- Surgical Innovation
- Transfusion Medicine
- Patient Safety
Background:
- Cell savers (CS) minimize allogeneic blood transfusions, crucial during shortages.
- This study explores user perspectives on CS in damage control surgery (DCS) in the Netherlands.
Purpose of the Study:
- To assess the perceived usability and usefulness of CS in DCS.
- To identify barriers and facilitators for CS implementation in DCS.
- To evaluate the suitability of CS and reinfusion of unwashed blood during shortages.
Main Methods:
- A survey was distributed to trauma surgeons and anesthesiologists in Dutch trauma centers and military hospitals.
- The survey utilized a five-point scale to evaluate logistics, training, experience, indications, and suitability of CS.
- Responses from 195 clinicians were analyzed.
Main Results:
- Most clinicians found CS very useful or essential in DCS (58-64%).
- Staff and disposables were generally available, but concerns included time consumption (23-40%), contamination risk (21-37%), and inadequate suction (10-19%).
- CS was deemed suitable for DCS during shortages (54-63%), but reinfusion of unwashed blood was less supported (25-62%).
Conclusions:
- Practical and clinical barriers, including time constraints and training gaps, may limit routine CS use in DCS.
- Addressing these barriers and linking findings to clinical outcomes can enhance autologous blood transfusion practices.
