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Erythrocytes and proinflammatory mediators in wound drainage
S Mottl-Link1, M Russlies, M Klinger
1Klinik für Orthopädie, Universität Lübeck, Deutschland. ts.link@t-online.de
Vox Sanguinis
|December 16, 1998
Summary
Postoperative shed blood retransfusion can cause side effects due to high levels of inflammatory mediators like histamine and prostaglandin E2 (PGE2) found in unwashed wound drainage. Further research is needed to understand these risks.
Area of Science:
- Transfusion Medicine
- Surgical Complications
- Biochemistry
Background:
- Autotransfusion of shed blood post-surgery is common but linked to adverse effects.
- Investigating the causes of these side effects is crucial for patient safety.
- Previous reports suggest potential issues with collected shed blood.
Purpose of the Study:
- To identify potential causes for side effects associated with retransfusion of shed blood.
- To analyze inflammatory mediators and erythrocyte integrity in collected surgical drainage.
Main Methods:
- A randomized study involving 28 patients undergoing total hip arthroplasty.
- Shed blood was collected using Solcotrans, Orth-Evac, and Redon drainage systems.
- Analysis included osmotic fragility, erythrocyte morphology, and measurements of serotonin, prostaglandin E2 (PGE2), and histamine.
Main Results:
- Elevated erythrocyte osmotic fragility in Solcotrans was linked to its anticoagulant (ACD).
- Significantly increased levels of histamine and PGE2 were found in shed blood compared to venous blood.
- Serotonin levels did not show significant differences.
Conclusions:
- Unwashed shed blood from surgical drainage contains elevated proinflammatory mediators.
- These mediators, including histamine and PGE2, likely contribute to reported side effects of blood retransfusion.
- Findings highlight the need for careful management of shed blood for autotransfusion.