Evaluating blood loss in children's orthopaedic surgery: a simplified method of photometric analysis of eluted swabs.
Assessment of intraoperative blood loss by the traditional method of weighing swabs (4 x 4-in. gauze) is propounded to estimate approximately 75% of total loss, although many believe this still underestimates actual loss. The various components of this technique were studied by using the method of colorimetric analysis of eluted swabs, but utilising a modern spectrophotometer. We modified and simplified the technique, resulting in > 95% accuracy in all instances, and by so doing, created a potential technique for use in children's orthopaedic surgery. Weighing swabs was found to estimate only approximately 50% of total loss, and this was supported in the pilot clinical study by a postoperative decrease in haemoglobin of 8-17%, despite transfusion, when transfusion was based on the traditional "75%" rule. Because it is impractical to elute theatre apparel and instruments to increase the accuracy of the elution method in the perioperative time scale necessary, a compromise may be to use the new "50%" rule as a better estimate of total blood loss when calculating transfusion requirements.
Keenan
W N
WN
Department of Orthopaedics, Coventry and Warwickshire Hospital, United Kingdom.
Griffiths
H
H
Clegg
J
J
D016063:Blood Loss, Surgical; D002138:Calibration; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures; D010865:Pilot Projects; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D013053:Spectrophotometry / Q000379:methods*
D006454:Hemoglobins; D011933:Reagent Kits, Diagnostic