Erythrocytes and proinflammatory mediators in wound drainage.
OBJECTIVE
Retransfusion of shed blood collected after operation has become popular, but recent reports of side effects led to a search for possible causes.


METHODS
In a randomized study of 28 patients undergoing total hip arthroplasty, shed blood was collected in Solcotrans, Orth-Evac, and ordinary Redon drainage. Osmotic fragility was measured and electron-microscopic pictures of erythrocytes from selective samples were taken. Serotonin, prostaglandin E2 (PGE2), and histamine were measured with enzyme-linked immunosorbent assays.


RESULTS
Higher osmotic fragility of erythrocytes collected with Solcotrans appeared to be due to ACD which was used only with that system. Serotonin concentrations did not differ significantly. However, there was a great increase in histamine (Solcotrans 477.7, Orth-Evac 344.0, Redon drainage 453.1 nmol/ml) and PGE2 (Solcotrans 1,908.3, Orth-Evac 1,225.0, Redon drainage 2,666.7 microgram/ml) in shed blood compared with venous blood (histamine 9.5 nmol/l, PGE2 4.2 microgram/ml).


CONCLUSIONS
Unwashed wound drainage blood collected after operation contains levels of proinflammatory mediators that can account for the reported side effects.
Mottl-Link
S
S
Klinik für Orthopädie, Universität Lübeck, Deutschland. ts.link@t-online.de
Russlies
M
M
Klinger
M
M
Seyfarth
M
M
Ascherl
R
R
Gradinger
R
R
D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000379:methods*; D019343:Citric Acid / Q000494:pharmacology; D015232:Dinoprostone / Q000009:adverse effects* / Q000097:blood; D004322:Drainage; D004912:Erythrocytes / Q000648:ultrastructure; D005260:Female; D005374:Filtration; D005947:Glucose / Q000031:analogs & derivatives / Q000494:pharmacology; D006632:Histamine / Q000009:adverse effects* / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009996:Osmotic Fragility / Q000187:drug effects; D012701:Serotonin / Q000009:adverse effects* / Q000097:blood; D014947:Wounds and Injuries
C002113:acid citrate dextrose; D019343:Citric Acid; D012701:Serotonin; D006632:Histamine; D005947:Glucose; D015232:Dinoprostone