Intraoperative blood salvage in excisional burn surgery: an analysis of yield, bacteriology, and inflammatory mediators.
The diminution of intraoperative hemorrhage remains a fundamental goal of the burn surgeon. We hypothesized that intraoperative blood salvage during burn excisions would be feasible if predicated on yield, bacteriology, and concentration of inflammatory mediators in the washed product. Reinfusion of culture-positive blood has a clear precedent in the trauma literature. Eight operations with immediate and complete collection of shed blood into a cell-saver device were prospectively studied. A median salvage rate of 43% of total shed red blood cells was estimated to have been recovered. Actual volumetric measurement of intraoperative blood loss was achieved. Bacterial contamination was consonant with the abdominal trauma experience. The levels of C3a, C5a, TNF alpha, and IL-1 beta in the final cell-saver product were all found to be at clinically insignificant levels.
Burn Center, Washington Hospital Center, Washington DC 20010, USA.
J C
JC
Jeng
T M
TM
Boyd
K A
KA
Jablonski
J D
JD
Harviel
M H
MH
Jordan
D000293:Adolescent; D000328:Adult; D000368:Aged; D001769:Blood / Q000382:microbiology*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001804:Blood Transfusion, Autologous; D002056:Burns / Q000601:surgery*; D015926:Complement C3a / Q000032:analysis; D015936:Complement C5a / Q000032:analysis; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007375:Interleukin-1 / Q000097:blood; D007432:Intraoperative Period; D008875:Middle Aged; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D018836:Inflammation Mediators; D007375:Interleukin-1; D014409:Tumor Necrosis Factor-alpha; D015926:Complement C3a; D015936:Complement C5a